[Show abstract][Hide abstract]ABSTRACT: Introduction: Malnutrition affects 20%-50% of all hospitalized patients and causes increased average stay in the hospital and increasing costs. The objective of this study, which was performed in an acutecare hospital, was to evaluate the possible relationship between the average hospitalization time and the conduction of an early nutritional evaluation. Materials and methods: The average hospitalization time in the 14 operative units involved in this study was evaluated, comparing 2 periods of equal duration (12 months). The first period was selected before the introduction of an Early Nutritional Evaluation procedure, and the second corresponded to the first year after the Early Nutritional Evaluation was introduced. The procedure was characterized by: (i) screening with the "Malnutrition Universal Screening Tool", performed within 24 hours from hospitalization; (ii) optional nutritional counseling within 24 hours from its request. Results: Among the 14 operative units considered, the 8 that performed an Early Nutritional Evaluation in a median of less than 20% of patients (average, 14%) did not substantially modify the length of the patients' hospitalization compared to the preceding period (+0.14 days, p=ns). Conversely, the 6 operative units that performed an Early Nutritional Evaluation in more than 20% of patients (average, 78%) did reduce the average length of patients' hospitalization by more than 1 day compared to the preceding time period (-1.15 days, p<0.05). Conclusions: This study shows a probable relationship between the application of Early Nutritional Evaluation and the reduction of the hospitalization time.
No preview · Article · Oct 2013 · Nutritional Therapy and Metabolism
[Show abstract][Hide abstract]ABSTRACT: The relationship between overt hypothyroidism and cardiovascular risk has been well documented and some data also suggest an association between cardiovascular risk and subclinical hypothyroidism. The aim of our study was to investigate, in a large cohort of euthyroid women, the association of thyroid stimulating hormone (TSH) within the normal reference range with cardiovascular risk factors. The study was carried out on 744 women with normal thyroid function (TSH 0.3-4.9 μU/mL). Women with TSH above the median (≥2.1 μU/mL) were more obese, had greater waist girth, were more hypertensive and had higher levels of total cholesterol (TC), serum triglycerides (TG), blood sugar (BG) and lower levels of HDL-cholesterol (HDL-C) than women with TSH below the median. TSH was significantly correlated with body mass index (BMI), waist circumference, BG, TG, TC, HDL-C and hypertension. Multiple backward stepwise regression analysis with age, waist circumference and TSH as independent variables confirmed the strong association of TSH with BG, TG, HDL-C and hypertension. A total of 205 patients (28%) fulfilled the definition criteria of the metabolic syndrome and the prevalence of metabolic syndrome was significantly greater in patients with TSH above than in patients with TSH below the median. Results of logistic analysis, including age and TSH as predictor variables, confirmed the association of TSH with metabolic syndrome.The results of this study suggest that TSH in the upper limits of the reference range (above 2.1 μU/ml) is associated with a less favourable cardiometabolic profile and consequently with a higher risk of developing cardiovascular diseases.
No preview · Article · Dec 2011 · Internal and Emergency Medicine