title: Malnutrition screening in acutely unwell elderly inpatients.
abstract: BACKGROUND
  The rate of malnutrition among hospitalised elderly patients in Australia is 42.3%. Malnutrition is known to lead to significant adverse outcomes for the patients and increase hospital costs through increased use of resources.
  
  
  OBJECTIVE
  This study assessed nutrition screening adequacy and investigated factors associated with missed opportunity to diagnose malnutrition.
  
  
  METHODS
  A prospective cross-sectional study involving 205 general medical patients aged ≥60 years admitted acutely in a tertiary hospital over a period of 1 year. Patients who were not given initial nutritional screening were noted and all patients underwent nutritional assessment. The researchers assessed demographic data and performed univariate analysis of factors responsible for missed nutritional screening.
  
  
  RESULTS
  Only 99 patients (49.5%) were screened for malnutrition and 100 (50.3%) missed initial nutritional screening (data incomplete for 6 patients). Of those screened, more were malnourished (n=64; 61.5%) than those not screened (n=40; 38.5%), p<0.001. There was no significant difference in screening rates over the weekends and public holidays compared with weekdays (p=0.14). Time of day (p=0.03) and ward location (p=0.001) were significant factors, which determined nutrition screening.
  
  
  CONCLUSIONS
  This study indicates common associations that might explain low inpatient screening rates for malnutrition; these include apparently adequate nutritional status, lower staff to patient ratios and outlier ward locations. Ensuring consistent nutrition screening with appropriate therapeutic interventions for patients and educational interventions for staff could pay dividends not only in terms of improved patient health but also in terms of hospital reimbursement.
authors.affiliation: Consultant Physician, Department of General Medicine, Flinders Medical Centre, South Australia and Senior Lecturer, School of Medicine, Flinders University, South Australia.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Sharma
authors.affiliation: Professor, Nutrition & Dietetics Department, Flinders University, South Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Miller
authors.affiliation: Lecturer, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Shahi
authors.affiliation: Clinical Epidemiologist, Department of Clinical Epidemiology, Flinders Medical Centre, South Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Hakendorf
authors.affiliation: Clinical Epidemiologist, Department of Clinical Epidemiology, Flinders Medical Centre, South Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Horwood
authors.affiliation: Professor of Medicine, Discipline of Medicine, University of Adelaide, South Australia.
authors.forename: Campbell
authors.initials: C
authors.lastname: Thompson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D015596:Nutrition Assessment; D011446:Prospective Studies
keywords: Elderly patients; Malnutrition; Nutrition screening