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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