The impact of in-hospital nutritional status deterioration on treatment outcome of adult gastroenterological patients; [Uticaj intrahospitalnog pogoršanja nutritivnog statusa na ishod lečenja odraslih gastroenteroloških bolesnika]

Abstract

Background/Aim. In the current literature, data on impact of intrahospital changes in patients’ nutritional status on the treatment outcome are limited. The aim of this study was to in-vestigate the relationship between nutritional status deterioration and the treatment outcome among hospitalized gastroenterological patients. Methods. In 650 adult gastroenterological patients nutritional status on admission and at discharge was evaluated using the 6 nutritional status assessment parameters: body mass index, triceps skinfold thickness, mid-upper arm muscle circumference, serum albumin concentration, lympho cyte count and unintentional weight loss. The influence on treatment outcome was tested for the nutritional status on ad-mission, nutritional status at discharge and intrahospital nutritional status deterioration. Results. The incidence of favorable outcome in the nonundernourished and undernourished patients on admission was in the range 93.4-97.3% and 81.2-91.2%, respectively. The incidence of favorable outcome in the non-undernourished and undernourished patients at discharge was in the range 94-97.4% and 80.8-88.1%, respectively. Fa-vorable outcomes were obtained in 95.6-98.9% of the patients without nutritional status deterioration and in 87.1-90.3% of the patients with nutritional status deterioration. Intrahospital nutritional status deterioration significantly influenced the out-come, no matter what assessment parameter had been used (p < 0.001 for all the applied parameters). Furthermore, only the deterioration of nutritional status was found to be an inde-pendent predictor of treatment outcome (multivariate analysis Forwald Wald, p ≤ 0.001; relative risk (RR) = 0.104-0.350; con-fidence intervals (CI) = 0.037-0.186/0.297-0.657). Conclu-sion. Deterioration of nutritional status is an independent pre-dictor of adverse outcome. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.