Starvation in the acute care hospital: A very common problem

The adequacy of caloric intake of geriatric patients in medical and surgical wards in the acute care hospital was assessed in a prospective, observational study. Fifty-one surgical and 80 medical nonterminal patients aged over 70 years underwent a multidimensional assessment on admission and a nutritional reassessment on discharge. The average daily caloric intake was also measured. Patients were divided into two groups according to whether the ratio of the actual to the needed caloric intake was inferior to 40% or not, and their differences, with regard to baseline values, were assessed. Patients whose caloric intake was inferior to 40% of the needed were older than the remaining ones (79.4 ± 6.6 vs 76.6 ± 4.9 years, p 0.05), had higher prevalence of preadmission functional dependency (21.6% vs 15%, p 0.001), lower body mass index (22.9 ± 5.4 vs 24.8 ± 3.9, p 0.004) and higher comorbidity (coexisting diseases: 3.6 ± 1.9 vs 2.8 ± 1.6, p 0.02) on admission. In conclusion, a simple assessment on admission allows targeting geriatric patients at risk for in-hospital starvation. No difference exists between surgical and medical wards in the quality of nutritional support.