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Other Hospital Pharmacy topics (including: medical devices)
Evaluation of malnutrition and vitamin D levels in an older medical unit
  1. C. Ripa,
  2. M. Gayan,
  3. M. Ercilla,
  4. B. Odriozola,
  5. J. Iturria,
  6. L. Leunda,
  7. P. Pascual,
  8. N. Mauleon
  1. 1Donostia University Hospital, Pharmacy, San Sebastián, Spain
  2. 2Donostia University Hospita, Pharmacy, San Sebastián, Spain
  3. 3Donostia University Hospital, Internal Medicine, San Sebastián, Spain

Abstract

Background Malnutrition among hospital inpatients is very high (30-50%). It has important consequences in patients' clinical course and in hospitalisation costs so early detection and establishment of corrective action is crucial. Vitamin D deficiency is also common in the older, and leads to decreased bone mass and increased fractures and healthcare costs.

Purpose Evaluate the nutritional status and vitamin D levels in an older medical unit. Evaluate whether corrective actions such as nutritional supplements or vitamin D prescription were established.

Materials and methods Nutritional status was assessed in 50 randomly selected patients using CONUT (COntrol NUTritional) system, a validated tool that determines nutritional status according to serum albumin, cholesterol and lymphocytes. 25-OH vitamin D levels (deficiency <12 ng/mL; insufficiency 12-30 ng/mL; normal 30-80 ng/mL) were also measured. Prescription of nutritional or vitamin D supplements was registered.

Results Medium age was 78.8 years. 22 were male and 28 female. Prevalence of malnutrition was very high (68%): It was mild in 19 patients (38%), moderate in 13 (26%) and serious in 2 (4%). Nutritional supplements were prescribed to just 6 patients (17,6%) with malnutrition. Forty-six patients (92%) had vitamin D levels below recommendations: 15 (30%) had vitamin D insufficiency (mean= 17.8; range 12.1-25.8 ng/mL) and 31 (62%) had deficiency (mean= 7.5; range 3-11.4 ng/mL). Calcium + vitamin D supplements were prescribed in eight (17.4%) patients with insufficiency or deficiency, three (7%) prescribed before admission and five (10.9%) during admission.

Conclusions Due to the high prevalence of malnutrition and hypovitaminosis D in the older, it would be advisable to establish a nutritional screening system and to measure vitamin D levels at admission, so that corrective action such as prescription of vitamin D or nutritional supplements prescription can be established. In addition, general practitioners should continue monitoring malnutrition and vitamin D after patients are discharged.

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