A third of patients are identified as malnourished on arrival at hospitals in Ireland

Conducted in November 2023 with data from 3,662 patients in 26 public hospitals across Ireland, the report highlighted a 34% increase in malnutrition on admission, compared to previous surveys in 2011 (32%) and 2010 (28%). However, the survey also found a significant reduction in malnutrition rates among patients in long-stay or rehabilitation services. This translates to 21% compared to 36% in all other services, and furthermore among those admitted from other hospitals rather than from home, to 26% compared to 35%.

It aims to highlight the effectiveness of the mandatory national screening and treatment protocols that were introduced in public hospitals in 2020.

The launch of the 2023 National Malnutrition Screening Survey has prompted calls from IrSPEN for screening to be extended to other clinical settings, including daycares and primary care settings.

The organization includes details of the recommendations in its 2025 pre-budget submission to reiterate the need for funding in the areas of additional malnutrition interventions.

Niamh Rice, co-author of the report and director of IrSPEN, said the survey identified two main reasons for the increase in the number of patients with risk factors for malnutrition.

“The first is an increase in the age range of patients presenting to hospitals, with older people more likely to be malnourished and the second is a higher incidence of cancer, leading to an increase in the number of cancer patients in the general hospital population (22% in November 2023 compared to 16% in 2011), with this cohort of patients also more likely to suffer from nutritional problems leading to malnutrition,” she said.

She expressed concern about the situation and added:

The level of malnutrition present in our public hospitals remains too high and some could be avoided if we pay more attention to improving the nutritional status of patients in the community.

“We need to expand malnutrition screening and treatment to all settings where cancer patients receive care, particularly in day services where they receive systemic cancer therapy (SACT), to facilitate rapid access to dietitians specializing in oncology, of which we only have a limited number. a handful across the country.

Ms. Rice also referred to other recommendations.

“A secondary recommendation is to fund an expansion of targeted malnutrition screening and treatment for frail older people, particularly those who live alone and require support at home,” she said.

“These patients typically visit their primary care physician and hospital emergency departments more frequently, which represents a significant cost to the healthcare system, due to falls and an increased need for care. In many cases, muscle loss due to increased nutritional needs or poor dietary intake (malnutrition) is a key factor leading to reduced quality of life, increased frailty and increased healthcare costs.”

Co-author and professor at King's College London and cancer research dietitian Dr Erin Stella Sullivan RD said there was a lot of confusion around the meaning of malnutrition, which she knows personally in helping cancer patients.

“There is a common misconception that we are skinny or underweight,” she said. “Yet if patients don't eat what they need during illness, the muscles break down in an attempt to provide the tissues with the protein building blocks needed to keep everything functioning properly. This phenomenon occurs even if patients have a high BMI and can even be hidden in these cases. »

She offered solutions, adding: “The effect of a screening and treatment programme is that patients who are losing weight or not eating enough protein, energy or other nutrients, which are usually needed in greater quantities during illness – are identified early, so that appropriate action can be taken; supplementation or nutritional support can be provided. The impact of improved nutritional status translates into a significant health gain for these patients – improving their resilience, their ability to adhere to treatment and improving their quality of life. There are also benefits to the health system, as healthier and stronger patients have fewer complications and better outcomes.”