Disorders of Biochemical Parameters Associated with Protein-energy Malnutrition in Adults Hospitalized in Ouagadougou, Burkina Faso

Abstract

The assessment of the nutritional status of the hospitalized person is often considered secondary to the pathologies justifying hospitalization. A multicenter study conducted in six Belgian hospitals showed a risk of malnutrition in just over one in five patients. This malnutrition during hospitalization is more frequent in the elderly and those with chronic pathologies. However, malnutrition is a very serious prognostic factor for hospitalized people because it multiplies the risk of infectious pathologies by two to six and the duration of hospitalization by two to four. This study is part of the promotion of better holistic care at the Yalgado OUEDRAOGO University Hospital Center (YO UHC) in Ouagadougou, Burkina Faso, which includes the assessment of the nutritional status of hospitalized people. A descriptive cross-sectional study with analytical aims over a period of nine (09) months was conducted. The study population consisted of people aged 50 and over in outpatient or hospitalized patients, recruited in the internal medicine department of YO UHC. Study variables included anthropometric parameters, blood count, specific nutritional and inflammatory proteins such as transthyretin, albumin, orosomucoid and C-reactive protein (CRP), as well as nutritional indexes such as the Body Mass Index (BMI), the Mini nutritional assessment (MNA) and the Prognostic inflammatory and nutritional index (PINI). Statistical analysis was performed using Epi info version 7.2.1.0. Were included 102 individuals consisted of 42 men and 60 women with a male/female sex ratio of 0.7. The mean age was 63±9 years with extremes ranging from 50 to 72 years. The mean values of the various anthropometric parameters were significantly lower in hospitalized patients compared to outpatients (p<10<sup>-3</sup>) with 50% of hospitalized patients having a BMI<21 kg/m<sup>2</sup>. The mean value of the MNA score was 13.67±4.83 in hospitalized patients compared to 21.57±3.24 in outpatients (p<10<sup>-4</sup>). The mean values of nutritional proteins were significantly lower in hospitalized patients with 55.9% having albuminemia <35 g/L and 47% having transthyretin <200 mg/L. For inflammatory proteins, the mean values were significantly higher in hospitalized patients with 29.4% having CRP >20 mg/L. The combined assessment reports that 50% of hospitalized patients had a PINI>1, of which approximately 15% had a vital risk (PINI>30). The results show a high frequency of protein-energy malnutrition accompanied by inflammatory syndrome in hospitalized people. Therefore, it is important to monitor the nutritional status of hospitalized people in order to avoid complications and an increase in the length of hospitalization.