Hospital malnutrition in Latin America: A systematic review

Clin Nutr. 2017 Aug;36(4):958-967. doi: 10.1016/j.clnu.2016.06.025. Epub 2016 Jul 19.

Abstract

Background: Disease-related malnutrition is a major public health issue in both industrialised and emerging countries. The reported prevalence in hospitalised adults ranges from 20% to 50%. Initial reports from emerging countries suggested a higher prevalence compared with other regions, with limited data on outcomes and costs.

Methods: We performed a systematic literature search for articles on disease-related malnutrition in Latin American countries published between January 1995 and September 2014. Studies reporting data on the prevalence, clinical outcomes, or economic costs of malnutrition in an adult (≥18 years) inpatient population with a sample size of ≥30 subjects were eligible for inclusion. Methodological quality of the studies was assessed by two independent reviewers using published criteria.

Results: We identified 1467 citations; of these, 66 studies including 29 ,474 patients in 12 Latin American countries met the criteria for inclusion. There was considerable variability in methodology and in the reported prevalence of disease-related malnutrition; however, prevalence was consistently in the range of 40%-60% at the time of admission, with several studies reporting an increase in prevalence with increasing duration of hospitalisation. Disease-related malnutrition was associated with an increase in infectious and non-infectious clinical complications, length of hospital stay, and costs.

Conclusion: Disease-related malnutrition is a highly prevalent condition that imposes a substantial health and economic burden on the countries of Latin America. Further research is necessary to characterise screening/assessment practices and identify evidence-based solutions to this persistent and costly public health issue.

Keywords: Assessment; Cost; Hospital; Malnutrition; Prevalence; Screening.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Combined Modality Therapy / economics
  • Communicable Diseases / economics
  • Communicable Diseases / epidemiology
  • Communicable Diseases / ethnology
  • Communicable Diseases / therapy
  • Comorbidity
  • Cost of Illness
  • Developing Countries
  • Hospital Costs
  • Humans
  • Latin America / epidemiology
  • Length of Stay
  • Malnutrition / economics
  • Malnutrition / epidemiology
  • Malnutrition / ethnology
  • Malnutrition / therapy*
  • Noncommunicable Diseases / economics
  • Noncommunicable Diseases / epidemiology
  • Noncommunicable Diseases / ethnology
  • Noncommunicable Diseases / therapy
  • Prevalence