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Disease Related Malnutrition
There are three main causes of disease related malnutrition and examples
of each are illustrated in Figure 3.
Figure 3: The causes of disease related malnutrition
| The causes of disease related malnutrition | ||
|---|---|---|
| Increased nutritional requirements | Infection Involuntary movement Trauma Major surgery |
|
| Reduced nutritional intake | Dysphagia Pain |
|
| Increased nutritional losses | Malabsorption/Diarrhoea Wound exudate |
|
Malnutrition from all of these aspects is inextricably linked and the
purpose of this strategy is to anticipate and ensure timely intervention of malnutrition irrespective
of the cause.
Why Address Malnutrition?
The detrimental effects of malnutrition are well documented as illustrated
in Figure 4.
Figure 4: Detrimental effects of malnutrition
| Physical | ||
|---|---|---|
| Impaired growth & development | ||
| Reduced fat & lean body mass | ↑ pressure sore risk | |
| Reduced strength & lethargy | ↓ mobility & ↑ falls | |
| Reduced ability to cough | ↑ risk of respiratory infections | |
| Physiological | ||
|---|---|---|
| Impaired immune function | ↑ risk of infection/complications | |
| Impaired organ function | ||
| Impaired wound healing | ↑ convalescence | |
| Altered drug metabolism | ↑ side effects | |
| Reduced gastro-intestinal secretions | ↑ malabsorption | |
| Psychological | ||
|---|---|---|
| Apathy & depression | ↓ quality of life | |
These may exist individually or collectively where they contribute to
increased length of hospital stay and mortality. Providing good nutritional care is therefore a matter
of quality14 .
Cost of Disease Related Malnutrition
The annual cost of disease related malnutrition in the UK in 2007 was
estimated to be more than £13 billion10.
This results from the health care cost of treating those at medium or high risk of malnutrition as a
result of more frequent and more expensive hospital inpatient episodes, and greater need for long term
care. Having a strategy in place for prevention, early identification and timely management of malnutrition
can improve quality of patient care and outcomes and make savings at the same time. NICE15
has identified nutritional care as potentially the 4th largest cost
saving within the NHS.
