Prospective assessment of malnutrition in urologic patients

The association between malnutrition and poor patient outcome has been established for different medical fields. There is a general lack of data on the prevalence of malnutrition in urologic patients. An assessment of malnutrition is needed to raise awareness of this condition and to initiate nutrition therapy if needed.

The nutritional state of 897 patients was assessed prospectively using the Nutritional Risk Screening 2002 (NRS) at a urologic department. Recruitment started in January 2007 and closed in July 2007. Of the 897 patients, 751 were men (84%) and 146 (16%) were women. The median age was 66 years (range 18-98). Of the 897 patients, 441 presented with benign disease and 456 with malignant disease.

A severe risk of malnutrition was diagnosed in 144 patients (16%; NRS score >or=3). The NRS score was 0, 1-2, and 3-5 in 45, 708, and 144 patients, respectively. Age and malignant disease were significant risk factors for malnutrition (P < .001). Also, the type of surgery was significantly associated with the risk of malnutrition (P < .001). Sex and body mass index had no significant influence. Of the patients with an NRS score of >or=3, 94% presented with >or=1 of the 3 risk factors: older age, open surgery, and/or malignant disease (P < .001).

In the present study, 16% of urologic patients were at a severe risk of malnutrition according to the NRS 2002. Older age, type of procedure, and malignant disease proved to be significant factors for a greater risk of malnutrition. Adequate nutritional supportive therapy should be considered in these patients to optimize their clinical outcome.