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House Call: Negative Consequences of malnutrition

Published: Oct. 9, 2020 at 6:08 PM EDT
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Last week we learned about the impact of malnutrition and how often it occurs. Today, we will even discuss the impact of malnutrition as it relates to COVID-19. Joining us once again, for part two of our two-part series concerning malnutrition is Wendy Phillips, MS, RD, CNSC, CLE, NWCC, FAND, Vice Chair of the Malnutrition Committee American Society for Parenteral and Enteral Nutrition (ASPEN).

1. What are some of the negative consequences of malnutrition?

Malnutrition is the result of not enough or an imbalance of nutrients. It can be related to both chronic and acute diseases. There are many negative outcomes associated with malnutrition.

a. Malnourished people may get sick more often and have to stay in the hospital longer when they get sick. This leads to higher hospital costs. Sadly, it can lead to a higher risk of dying while in the hospital or soon after discharge.

b. Malnourished patients who visit the emergency department have a 17% higher chance of being hospitalized, because of the malnutrition itself or because their chronic disease is made worse by malnutrition.

c. Government data shows that malnourished patients:

i. stay in the hospital 2X longer

ii. have 2X higher hospital costs

iii. are 3X higher more likely to die in the hospital

iv. are 1.6X more likely to readmitted within a short time

2. Which hospitalized populations have higher rates of malnutrition?

Many factors affect malnutrition rates in hospitalized patients.

a. Adults 65 and older are in the highest risk category, and the risk continues to increase as people age.

b. Black hospitalized patients 14% higher than white patients (replace graphic with chart including Hispanic)

c. Hospitalized patients in the lowest income groups have a 40% higher rate, which is why the issue of social determinants of health has deservedly gained national attention.

3. Do you have any information on malnutrition and Covid-19 patients?

I think of malnutrition and COVID-19 as a double-edged sword. People suffering from malnutrition are at higher risk for infectious diseases, including COVID. Likewise, infections like COVID impair the immune function and increase nutrient needs. It can lead to taste changes, fatigue, and other problems that affect nutrient intake, causing an increased risk to develop malnutrition.

All hospitalized patients, including those with COVID, should be screened for malnutrition and referred to a registered dietitian for a full nutrition assessment and care plan if malnutrition is suspected. Patients who require ventilators will need tube or IV feeding. The American Society for Parenteral and Enteral Nutrition, ASPEN, published guidelines to guide doctors and dietitians, and other healthcare providers on how best to provide this therapy.

ASPEN also released a couple of nutrition and hydration tip sheets for COVID-19 patients recovering at home. They can be found at www.nutritioncare.org/covid19 under the “Patient Education” section.

Malnutrition is a preventable and treatable disease. Today is the last day of ASPEN’s Malnutrition Awareness Week—our annual, week-long program to educate healthcare professionals and consumers on how to spot and treat malnutrition. Senator Chris Murphy from Connecticut just introduced a Senate Resolution designating the week of October 5-October 9 as Malnutrition Awareness Week. We hope viewers will contact their senators and ask them to support this legislation.

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