Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

• Published in: European journal of clinical nutrition Vol. 64; no. 8; pp. 894 - 898
• Main Authors: Cereda, E, Lucchin, L, Pedrolli, C, D'Amicis, A, Gentile, M.G, Battistini, N.C, Fusco, M.A, Palmo, A, Muscaritoli, M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-08-2010; Nature Publishing Group
• Subjects: 692/699/1702/295; 692/700/1538; 692/700/478/2772; Adequacy; anthropometric measurements; Anthropometry; Attitude of Health Personnel; Attitudes; Biochemistry; Biological and medical sciences; Biomarkers - analysis; blood chemistry; Body Mass Index; Body size; Body weight loss; Care and treatment; Clinical Competence; Clinical Nutrition; comorbidities; Comorbidity; complications; Delivery of Health Care - standards; Energy Intake; Epidemiology; Feeding. Feeding behavior; Food and nutrition; Food intake; Fundamental and applied biological sciences. Psychology; Guidelines as Topic; health monitoring; Hospital patients; Hospitalization; hospitals; Humans; Iatrogenesis; iatrogenic disorders; Inpatient care; Internal Medicine; Italy - epidemiology; Malnutrition; Malnutrition - diagnosis; Malnutrition - epidemiology; Malnutrition - therapy; Management; Medical nutrition therapy; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Nutrition Assessment; Nutrition monitoring; Nutrition Surveys; Nutrition therapy; nutritional intervention; nutritional risk screening tool; Nutritional Sciences; Nutritional status; nutritional support; Nutritional Support - statistics & numerical data; Nutritional Support - utilization; original-article; Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...); patient care; Patients; Public Health; Risk Assessment; Risk factors; Routines; signs and symptoms (animals and humans); standards of nutritional care; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight Loss; Italy; Europe; iatrogenic malnutrition; nutritional support; nutritional risk; disease-related malnutrition; nutritional routines; nutritional practices; Iatrogenic; Nutrition; Nutrition disorder; Metabolic diseases; Risk; Care; Professional practice; Risk factor; Malnutrition; Food supplement
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2010.85

Background/Objectives: Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies. Subjects/Methods: Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) <18.5 kg/m2 or significant weight loss (>or=10% in 3 months and/or >or=5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected). Results: In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; P<0.001). Conclusion: Present results confirm that in Italy, nutritional care routines are still poor and need improvements.