Malnutrition in Acute Care Surgery Patients in Rwanda

Egide Abahuje, Irenee Niyongombwa, David Karenzi, Jeanne D’ Arc Bisimwa, Eugene Tuyishime, Faustin Ntirenganya, Jennifer Rickard

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1 Scopus citations

Abstract

Introduction: Malnutrition is prevalent in hospitalized surgical patients and has been shown to significantly alter outcomes including length of hospital stay, complications, and mortality. Different tools for nutrition assessment were developed and are being used. The aim of this study was to characterize the nutritional status of acute care surgery patients, determine risk factors for malnutrition, and describe outcomes in patients with malnutrition. Methods: This was a prospective, descriptive study of malnutrition in acute care surgery patients at CHUK. Over a 6-month time period, we collected data on demographics, diagnosis, operation, and patient outcomes. We assessed the incidence of malnutrition using the American Society for Parenteral and Enteral Nutrition (ASPEN) guidelines and Subjective Global Assessment (SGA). We reported frequencies and percentages for categorical variables and median and interquartile range (IQR) for continuous variables. Results: We analyzed data for 279 acute care surgery patients. Most (n = 209, 73%) patients were male. The median duration of symptoms was 5 days (IQR 2, 14). The most common diagnoses were trauma (n = 83, 30%), intestinal obstruction (n = 76, 27%), and peritonitis (n = 49, 18%). Most (n = 210, 73%) patients underwent operation. The median length of hospital stay was 6 days (IQR 4, 11). Using ASPEN guidelines, 99 (35%) patients had evidence of malnutrition on hospital admission and 76 (27%) had evidence of malnutrition using SGA. After 1 week of hospital stay, 48 (41%) patients had evidence of malnutrition. Overall mortality was 3%, with higher mortality seen in patients with malnutrition (8% vs. 0.6%, p = 0.001). The length of hospital stay was longer in patients with malnutrition on hospital admission (6 days vs. 5 days, p = 0.044). Conclusions: Acute care surgical patients present to the hospital at high-risk for malnutrition. Efforts are needed to ensure that surgical patients receive adequate nutrition support to improve patient outcomes and minimize complications.

Original languageEnglish (US)
Pages (from-to)1361-1367
Number of pages7
JournalWorld Journal of Surgery
Volume44
Issue number5
DOIs
StatePublished - May 1 2020

Bibliographical note

Funding Information:
This research was supported by funding from University Teaching Hospital of Kigali. This research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences.

Publisher Copyright:
© 2020, Société Internationale de Chirurgie.

PubMed: MeSH publication types

  • Journal Article
  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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