Nutrition status of patients during hospitalization, Tehran, Iran

We assessed the nutrition status of patients on admission and monitored changes during hospitalization at Shariatri Educational Hospital, Tehran, Iran.

One hundred fifty-six randomly selected patients from 9 different wards were assessed. Body mass index (BMI) and body composition (based on bioelectrical impedance) were measured on admission and discharge. A questionnaire was also completed to evaluate general physical, psychological, and living status of the patients. Medical records were audited to identify when nutrition consultation, nutrition support, and nutrition-related laboratory factors (serum levels of total lymphocyte count [TLC] and albumin) were ordered. Frequency and paired t-test were used to analyze data.

Undernutrition (BMI <18.5 kg/m(2)) was present in 5.7% of the patients on admission, and severe undernutrition (BMI <16 kg/m(2)) existed in 0.6%. When discharged, 11% of patients were undernourished, and the prevalence of severe undernutrition increased to 1.3%. Average body weight and BMI decreased significantly during hospitalization (p < .001). Body composition analysis showed a significant reduction in body protein mass (p < .001). During hospitalization, body water percentile decreased and body fat percentile increased but not significantly. Only 1 patient was supported with parenteral nutrition (PN) and 1 with enteral nutrition. Orders for nutrition consultation were present in 1.9%, TLC levels in 10.8%, and serum albumin levels in 7% of the patient medical records surveyed.

Undernutrition increased in patients during hospitalization. According to the low rate of nutrition-related orders, one potential cause of worsening nutrition status may be inadequate medical staff awareness about the importance of nutrition in hospitalized patients.