Weight Change During Hospitalization in a Tertiary Cardiological Center in Sri Lanka

Malnutrition is common in hospitalized patients and many undergo further deterioration of the nutritional level during the stay at the hospital. Patients who are malnourished on admission have a tendency to further depletion of nutrition level during the hospital stay. The aim of this study was to assess the weight changes of hospitalized patients during the hospital admission. Body weight was measured on admission and discharge for two hundred and ninety four patients in a cardiology hospital. Body mass index (BMI) cut offs were used to categorized patients to underweight (BMI<18.5kg.m-2), normal (18.5-22.9kg.m-2), overweight (23.0-24.9kg.m-2), obese (25.0-29.9kg.m-2) and very obese. Study population included 190 (64.4%) males and 105 (35.6%) females. One hundred and twenty eight (43.4%) patients lost their weight, while 131 (44.4%) and 36 (12.2%) patients had gained and had no change in their weight respectively. Of the patients who had their BMI in the underweight category (26, 8.81%), most (15, 57.7%) gained their weight. In the normal BMI range (112, 37.97%) majority (51, 45.5%) gained their weight. In the category of overweight (64, 21.69%), half of the patients (32, 50.0%) lost their weight. Forty three patients (46.23%) who were in the obese or very obese category (93, 31.53%) lost their weight. Weight changes withi

Predicting clinical outcome of cardiac patients by six malnutrition screening tools

BACKGROUND: Malnutrition is highly prevalent among hospital admissions and associated with, poor response to medical treatment, prolonged hospital stay, increased mortality and cost to the state. The aim of this study is to assess the ability of the nutrition screening tools to predict the clinical outcome of cardiac patients. METHODS: Five hundred and twenty six patients underwent nutritional screening via Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Short Nutritional Assessment Questionnaire (SNAQ), Mini Nutritional Assessment-Short Form (MNA-SF), Nutritional Risk Screening (NRS) and Subjective Global Assessment (SGA) tools on admission and each subject was followed up until discharge and after one month to identify the clinical course and outcome. RESULTS: The mean hospital stay was 5.3 days and median hospital stay was 4.0 days. The mean hospital stay is increasing with the malnutrition level in MUST, NRS, MNA-SF, MST, NRS and SGA tools. The inpatient mortality is higher in high risk nutritional categories of all six malnutrition screening tools. MNA-SF, MST and SGA tools demonstrate a positive relationship between non-prophylactic antibiotic usage and poor nutritional status. High risk nutritional categories of MNA-SF and MST are associated with prescription of multivitamin/minerals. According to MNA-SF, MST and SGA the follow up mortality was increased with worsening nutritional status. The incidence of readmissions was increased gradually with deteriorating nutritional status categorized by MUST, SNAQ, MST and SGA tools. CONCLUSION: Malnutrition may be associated with poor clinical outcome of the cardiac patients during and after the hospital stay. Each tool reported a variable prediction in outcomes such as death, infection and prolonged hospital stay due to the poor nutritional status

Additional file 1: of Body weight perception among Sri Lankan cardiac patients

Multiple logistic regression models for under-perception, correct perception and over perception of body weight. (DOCX 17 kb

Active screening of patients with diabetes mellitus for pulmonary tuberculosis in a tertiary care hospital in Sri Lanka.

End TB strategy by the WHO suggest active screening of high-risk populations for tuberculosis (TB) to improve case detection. Present study generates evidence for the effectiveness of screening patients with diabetes mellitus (DM) for Pulmonary TB (PTB). A study was conducted among 4548 systematically recruited patients over 45 years attending DM clinic at the National Hospital of Sri Lanka. The study units followed an algorithm specifying TB symptom and risk factor screening for all, followed by investigations and clinical assessments for those indicated. Bacteriologically confirmed or clinically diagnosed PTB were presented as proportions with 95% CI. Mean (SD) age was 62·5 (29·1) years. Among patients who completed all indicated steps of algorithm, 3500 (76·9%) were investigated and 127 (2·8%) underwent clinical assessment. Proportion of bacteriologically confirmed PTB patients was 0·1% (n = 6,95%CI = 0·0-0·3%). None were detected clinically. Analysis revealed PTB detection rates among males aged ≥60 years with HbA1c ≥ 8 to be 0·4% (n = 2, 95%CI = 0·0-1·4%). The study concludes that active screening for PTB among all DM patients at clinic settings in Sri Lanka, to be non-effective measure to enhance TB case finding. However, the sub-category of diabetic males with uncontrolled diabetics who are over 60 years of age is recommended as an option to consider for active screening for PTB