Abstract Information


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.


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