THE CHANGE IN MINI-NUTRITIONAL ASSESSMENT (MNA) SCORES ON ADMISSION AND DISCHARGE FROM AN ASIAN COMMUNITY HOSPITAL
C.P. Phua, S.Y. Tan, E.T. Boen, S.M. Yu, T.Z. Ho
J Aging Res Clin Practice 2013;2(1):57-60
There is a high prevalence of malnutrition in local nursing homes and hospitals.1,2 As such it is important to develop a systemic and practical approach to identify this group at patients during their stay in community hospitals to improve their clinical outcome. Aims: Our objectives are to find out the prevalence of malnutrition in elderly (age > 65) patients on admission and on discharge from a community hospital and develop a quality indicator to assess patients’ change in nutritional status. Methods: The mini-nutritional assessment administered for geriatric patients (age ≥65 years old) admitted to a community hospital over a 3 month period on admission and before discharge. Demographics data, Charlson Score, Modified Barthel Index score (on admission and before discharge), mode of feeding and length of stay are also obtained. The newly proposed nutritional improvement score, the Inpatient Nutritional Improvement Score is calculated by the following formula: (Mini-nutritional assessment score on discharge minus score on admission) / Mini-nutritional assessment score on admission. Results: 33.8% of the patients were malnourished on admission using the mini-nutritional assessment. The mean Inpatient Nutritional Improvement Score was 0.19. The factors correlated with a higher score are presence of nasogastric tube on admission, oral supplements and a longer length of stay. Age, initial Barthel, Charlson score, race, gender (Chinese) and number of dietitian reviews were not significantly related with the Inpatient Nutritional Improvement Score. Conclusion: There is a high prevalence of malnutrition in the community hospital. The proposed Inpatient Nutritional Improvement Score is simple to calculate and is useful to track the nutritional improvement of patients in a community hospital.