[Introducing a mixed nutritional screening tool (CIPA) in a tertiary hospital].

Abstract

INTRODUCTION: Malnourishment in hospitalized patients is very prevalent and therefore it is important to implement screening methods. A mixed nutritional screening method (CIPA) has been developed at our center; this method includes four parameters: (a) control of intakes for 72 h; (b) BMI; (c) proteins; and (d) albumin. OBJECTIVES: (1) To know the prevalence of malnourishment at the Internal Medicine Department of our Center; (2) To analyze the variables associated to higher prevalence of malnourishment. MATERIALS AND METHOD: The results of the nutritional screening tests carried out in 305 patients admitted to the Internal Medicine Department in the period of November of 2012-October of 2013 were retrospectively reviewed. The prevalence of hospital malnourishment was analyzed, as well as the association of a positive screening test (at least one positive item) with the following variables: BMI, age, gender, underlying disease, hospital staying, early re-admittance (< 1 month) and hospital mortality. RESULTS: The test yielded a positive result in 23% of the patients. Patients with a positive screening test had lower BMI (24.9 ± 7.2 vs. 27.8 ± 6.4 kg/m; p = 0.002). Neoplastic and infectious pathologies were associated with greater positivity (35.3 and 28.9%, respectively; p = 0.006). Gender and age were not associated with a positive screening test. Patients with a positive screening test had longer mean hospital staying (26.7 ± 25 vs. 19.4 ± 16.5; p = 0.005), higher early re-admittance rates (18.6 vs. 6.8%; p = 0.003) and higher mortality (30 vs. 10.3%; p < 0.001). CONCLUSIONS: The CIPA screening test can detect malnourished patients and predict worse clinical prognosis (mortality, mean hospital staying and early readmittance).