[Screening and treatment of malnutrition: European Council Resolution and its potential application in Switzerland].

Unité de Nutrition, Hôpitaux Universitaires de Genève.
Revue medicale de la Suisse romande 11/2004; 124(10):617-23.
Source: PubMed


The deleterious consequences of hospital malnutrition are progressively being recognized by the public. The Committee of the Ministers of the European Council has released a resolution for food and nutrition and ask the state members to apply national recommendations in their hospitals. The evaluated domains and actions to be undertaken are based on 4 elements: Access to a healthy and varied food supply is a fundamental human right; a high number of patients hospitalized in Europe are malnourished (30-60%); the demonstration that malnutrition of hospitalized patients increases length of hospital stay and medical costs; the demonstrated beneficial effects of a hospital food service and of optimal nutritional care on morbidity, healing and quality of life. The resolution indicates clearly the options to be followed to optimize the actions and decisions at three levels: patient care, support services, and administration. All caregivers must be involved in the implementation of the recommendations in a way to adapt them to the local needs and restrictions. This review summarizes the actions to be taken by medical and other caregivers in order to sensitize them to the above-mentioned problems and to initiate practical options to treat malnourished patients or patients at risk of becoming malnourished.

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    • "Still, more than one hundred years later, Hill et al. [1] found that 50% of surgical patients and 40% of medical patients were malnourished. In the majority of these patients, this risk increases during hospitalization [2]. As malnutrition in hospitalized patients is underdiagnosed, 70–80% of the malnourished are not identified as such. "
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    ABSTRACT: Background. Malnutrition in hospitalized patients is underdiagnosed, with 30 to 60% of patients admitted being malnourished. The objective of this study was to investigate the nutritional status of patients in a general surgery ward and to define the correlation between the risk of malnutrition and the hospital course and clinical outcome. Study design. The study group included 100 consecutive patients admitted to a general surgery ward who were ambulant and could undergo the Malnutrition Universal Screening Tool (MUST). Results. Thirty-two patients (33%) had aMUST score of 2 or higher, and were therefore defined at high-malnutrition risk. The patients at risk had longer hospitalization and worse outcome. The length of stay of the malnourished patients was significantly longer than that of patients without malnutrition risk (18.8 ± 11.5 vs. 7 ± 5.3 days, P = .003). Mortality in the high-risk group was higher overall, in hospital, and after six months and one year of followup. Conclusions. Medical personnel must be aware that malnutrition afflicts even patients whose background is not suggestive of malnutrition. Best results are achieved when cooperation of all staff members is enlisted, because malnutrition has severe consequences and can be treated easily.
    Full-text · Article · Jan 2011 · Gastroenterology Research and Practice
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    ABSTRACT: PEG (percutaneous endoscopic gastrostomy) has by now become a widely used method, especially to ensure long-term enterai nutrition. In developed countries nearly 1 in 1000 people have a PEG. Although the use of PEG increases year by year in Hungary, it is still performed too rarely or too late. PEG is an invasive but simple endoscopic technique that may be carried out even at the patient's bed. In cases when the routinely used oral route for oesophago-gastro-duodenoscopy is impossible one of the following alternative ways can be chosen: endoscopy via a laryngoscope, through the opened pharynx, through a large pharyngo-oesophageal fistula or transnasally. These allow the bypassing of stenoses and the placement of PEG. There are few absolute contraindications and complications occur rarely. Early treatment and follow-up of dermatitis is important since it may be the first sign of severe complications. PEG tubes may function for many years with proper maintenance. Feeding via PEG tubes is especially effective in head and neck malignancies or injuries and in neurological disorders. In surgery it can be used for the management of surgical complications or for decompression of the stomach and duodenum. PEG-feeding is common in geriatrics and in paediatrics, sometimes with questionable indications. If used with adequate indications, ethical considerations, wise forethought, and a decision made together with the patient and family, PEG may improve lifespan and quality of life, decrease complications and side effects of the therapy and owing to its cosmetic benefits it facilitates re-socialisation.
    No preview · Article · Jun 2006
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