ESPEN Congress Istanbul 2006

Transkript

1 ESPEN Congress Istanbul 2006 Malnutrition in the hospitals: Still big problem Nutritional risk of the hospitalized patients at the Turkish hospitals G. Korfali (Turkey)

2 NUTRITIONAL RISK OF HOSPITALIZED PATIENTS AT THE TURKISH HOSPITALS G Korfalı, H Gündoğdu, S Aydıntuğ, M Bahar, T Besler, A R Moral, M Oğuz, M Sakarya, M Uyar, S Kılıçturgay

3 Undernutrition is associated with increased Complications Increased mortality Prolonged length of stay Increased cost of hospitalization

4 Aims To assess: The nutritional risk at admission, Iatrogenic malnutrition, The status of nutritional support in Turkish hospitals

5 Methods A multicentre, prospective study conducted by The Society of Turkish Enteral and Parenteral Nutrition University and Teaching hospitals A database which offered an online access of the patients records was designed.

6 Methods Nutritional Risk Screening NRS-2002 Patients were screened within 24 hrs of admission, Nutritional evaluation was repeated once a week, Nutritional support was recorded, The patients who underwent a clinical intervention were not included.

7 turkey map Road map of turkey türkiye haritası karayolları haritası türkei karte landkarte der Tuerkei map of Antalya haritası map of İstanbul haritası map of İzmir haritası map of Ankara haritası map of Bodrum map of Marmaris map of Datca map of Koycegiz map of Dalyan map of Fethiye map of Erzurum haritası map of Adıyaman haritası map of Afyon haritası map of Ağrı haritası map of Amasya haritası map of Artvin haritası map of Aydın haritası map of Balıkesir haritası map of Bilecik haritası map of Bingöl haritası map of Bitlis hatitası map of Bolu hatitası map of Burdur hatitası map of Bursa hatitası map of Çanakkale haritası map of Çankırı haritası map of Çorum haritası map of Denizli haritası map of Diyarbakır haritası map of Edirne haritası map of Elazığ haritası map of Erzincan haritası map of Eskişehir haritası map of Gaziantep haritası map of Giresun haritası map of Gümüşhane haritası map of Hakkari haritası map of Hatay haritası map of Isparta haritası map of İçel haritası map of Kars haritası map of Kastamonu haritası map of Kayseri haritası map of Kırklareli haritası map of Kocaeli haritası map of Konya haritası map of Kütahya haritası map of Malatya hatitası map of Manisa haritası map of Kahramanmaraş haritası map of Mardin haritası map of Muğla haritası map of Muş haritası map of Nevşehir haritası map of Niğde haritası map of Ordu haritası map of Rize haritası map of Sakarya haritası map of Samsun haritası map of Siirt haritası map of Sinop haritası map of Sivas haritası map of Tekirdağ haritası map of Tokat haritası map of Trabzon haritası map of Tunceli haritası map of Şanlıurfa haritası map of Uşak haritası map of Van haritası map of Yozgat haritası map of Zonguldak haritası map of Aksaray haritası map map of of Bayburt haritası map of Karaman haritası map of Kırıkkale haritası map of Batman haritası map of Şırnak haritası map of Bartın haritası map of Ardahan haritası map of Iğdır haritası map of Yalova haritası mapof Karabük haritası mapof Kilis haritası map of Osmaniye haritası mapof Düzce haritası marmaris bodrum çeşme alanya side manavgatçıldır gölü tuz gölü van gölü ishak paşa sarayı nemrut ağrı dağı belek uludağ mevlana türbesi nasreddinhoca turuva atı aspendosfinikefethiye kaş selimiye cami süleymaniye kemer ayvalık urla foça iskenderun köyceğiz didim hotels village 19 CITIES LOCATED IN DIFFERENT REGIONS IN TURKEY 6 CENTERS 2 CENTERS 11 CENTERS 2 CENTERS 2 CENTERS 34 HOSPİTALS

8 15 June January User name / Name Patient data Age Center Department Disease First NRS score Nutritional support yes / no Second NRS score Nutritional support yes / no Third NRS score

9 Results ; evaluation

10 RESULTS 18824(64.7% ) Age 10315(35.3% ) >60 Age

11 RESULTS % n % Surgery I. Medicine

12 NRS-2002 score on admission to hospital Department n= 3/<3 Percentage INTERNAL MEDICINE 242/ ,4 ENDOCRINOLOGY 44/504 8,7 GASTROENTEROLOGY 321/ ,1 NEFROLOGY 97/533 18,1 HEMATOLOGY 88/ MEDICAL ONCOLOGY 377/867 43,4 CARDIOLOGY 117/ ,3 PUMONARY DISEASE 157/881 17, hospitalized patients 15 % were nutritionally at risk NEUROLOGY 350/ ,9 RHEUMATOLOGY 47/719 6,5 GENERAL SURGERY 1008/ ,6 THORACIC SURGERY 27/148 18,2 CARDIAC SURGERY 32/292 10,9 NEUROSURGERY 137/795 17,2 ORTHOPEDIC SURGERY 92/1580 5,8 UROLOGY 68/783 8,6 EAR NOSE THROAT (ENT) 56/1416 3,9 RADIOLOGY ONCOLOGY 102/523 19,5 ICU 861/ GASTROENT SURGERY 144/786 18,3

13 RESULTS 15% of hospitalized patients were nutritionally at risk 51,8% of patients with NRS-2002 score 3 received nutritional support

14 RESULTS 2.NRS 5505 (18.9%) patients were rescreened Iatrogenic malnutrition occurred in 6,25% at the end of the first week Among 764 patients that received nutritional support during the first week, the NRS score of 563 patients were still 3 (%73.7)

15 RESULTS 3.NRS 2339 (7.9%) patients re-screened (3.NRS) In 1.8% of patients screened during multiple weeks, nutritional risk developed for the first time after two weeks in the hospital - 83% of patients receiving nutritional support for two weeks were found to be at nutritional risk

16 CONCLUSION - 1 The prevalence of nutritionally at-risk patients among 29,136 hospitalized Turkish patients was 15% Oncology patients were more nutritionally at risk than other patient groups With minimal training, nutritionists effectively used the NRS 2002 to assess nutritional status

17 CONCLUSION - 2 Results of nutritional screening assesments and nutrition care plans should be communicated to other healtcare professionals Iatrogenic malnutrition is still a problem in Turkish inpatients Long-stay hospitalization is associated with iatrogenic malnutrition

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