An Italian investigation on nutritional risk at hospital admission : the PIMAI (Project: Iatrogenic malnutrition in Italy) study

Background & aims: Nutritional risk on admission to hospital, which turns out to be high in most countries, was investigated. However, when consulting the "malnutrition-mapping" in Europe, the lack of Italian data raises attention. Accordingly, we designed a multidisciplinary, cross-sectional survey: the PIMAI study (Project: Iatrogenic MAlnutrition in Italy). Methods: Patients were enrolled from 13 large (>400 beds) multidisciplinary hospitals. Randomly selected adult (>18-year-old) patients were included according to a 4-strata model by gender and age (<65 and ≥65 years). Nutritional risk was assessed by the Nutritional Risk Screening 2002 tool. Results: A total of 1284 patients were evaluated. Overall prevalence of nutritional risk was 28.6% with similar distribution between sexes and higher rates in medical rather than in surgical departments (33.6% vs 22.8%; p < 0.0001). Risk prevalence was markedly heterogeneous among specialties, ranging between 4.8% (ophthalmology) and 62.5% (oncology units). Moreover, in adults aged 18-65 years the prevalence of "risk of malnutrition" was significantly lower than in those ≥65 years (18.3% vs 41.9%; p < 0.0001). Conclusions: The prevalence of nutritional risk on admission to hospital is high also in Italy. However, in patients aged 18-65 years nutritional risk appears a less prevalent comorbidity, thus supporting the role of age as an important determinant.