S BAHCECI1, M CHAN1, K EVANS2
1St George Hospital , Sydney, Australia, 2The Sutherland Hospital, Sydney, Australia
Aim: This study aimed to examine the relationship between the clinical profile, prevalence of malnutrition, and length of stay (LOS) in a cohort of renal patients admitted to an acute tertiary hospital.
Background: Malnutrition is common among renal patients, and is associated with morbidity, mortality, and hospitalisation including increased LOS.
Methods: A retrospective audit was conducted on data routinely collected for patients admitted under the renal medicine team over 11 months. Data collected included demographics, clinical presentation, LOS, nutritional profile including Subjective Global Assessment (SGA) score, history of dietitian involvement and the need for dietitian follow up post discharge.
Results: Records of 218 patients were reviewed. The average number of renal admissions was 12.8±3.9 per day, with 45.4±15.9% of patients under the care of the dietitian, either referred or automatic referral as per department policy.
The mean age of patients was 68.0±14.3 years. The prevalence of malnutrition was 63.6% (SGA=B and C). The LOS period between well nourished (SGA=A) vs. malnourished (SGA=B and C) was 12.2±11.5 vs. 16.5±22.6 days respectively, p=0.09 and was considered clinically significant. All malnourished patients required ongoing nutrition support by dietetics post discharge.
Conclusions: Malnourished renal inpatients tended to have longer LOS which has implications for clinical practice. Malnutrition management prior to, during, and after hospital discharge is likely to make a difference to LOS. Therefore, a multidisciplinary team approach to early identification of malnutrition for dietetic referral is vital to ensure continuum of care.
Su Bahceci is a clinical dietitian working at St George Hospital, Sydney with extensive experience in a number of medical and surgical areas and has been specialising for over four years in the renal acute inpatient and chronic outpatient areas. She has undertaken post-graduate training in renal nutrition. Su has a vested interest in research, particularly in nutrition support for malnourished renal patients and examining the role of intradialytic parenteral nutrition on nutritional outcomes. She is also enthusiastic about mentoring fellow dietitians and students in the area of renal nutrition.