Malnutrition after spinal cord injuries: a systematic review
1Wong S, 1Kenssous N, 1Lewis S, 2Jamous A, 1Saif M
1National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, , UK; 2Royal Buckinghamshire Hospital, Aylesbury, , UK
Introduction: Malnutrition is a major clinical and public health issue after spinal cord injury (SCI) but little is known about the prevalence of malnutrition in SCI patients.
Methods: We searched Medline, Embase, Cochrane Database of Systematic Reviews, DARE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, AMED and HTA database for articles on disease-related malnutrition in SCI patients. Any articles in English were included. Outcomes include the prevalence of malnutrition or clinical outcomes of malnutrition in SCI patients with a sample size at least 20 subjects eligible for inclusion. The quality of the studies’ methodology was assessed by two independent reviewers using published criteria.
Results: Eighty-four articles were identified, of these, 11 studies (n=9 adult SCI; n=2 children with SCI), including 9,382 SCI patients met the criteria for inclusion. There was considerable variability in methodology and in the reported prevalence of malnutrition risk. Four nutrition-risk screening tools were reported, prevalence was consistently in the range of 40-50% for adult SCI patients and 47-51% for children with SCI at the time of admission. Three different body-mass-index cut-offs were reported as over-nutrition’s cut off. The prevalence of overnutrition-risk was consistently in the range of 45-65%. Undernutrition-risk was associated with an increase in clinical complications, length of hospital stay and mortality.
Conclusion: Malnutrition is a highly prevalent condition after SCI that impose a substantial health and economic burden in SCI system. Further research is necessary to characterise screening practices and identify evidence-based interventions to this persistent and costly clinical and public health issue.
You Must Be Logged In
This Reminders tab will display for your scheduled lectures 15 minutes before start time and for new messages waiting.