Malnutrition multiplied by five the risk of nosocomial infections

A study conducted at the University Hospital of Nice shows that malnutrition increases five-fold the risk of nosocomial infections, said Dr. wavier Hebuterne, gastroenterologist at the Hospital Archet 2, during a press conference in MEDEC which opened its doors in Paris.
Malnutrition in general and sarcopenia in particular are a problem not well known in Europe and in France, where data are scarce. The consequences of these two nutritional states are yet heavy, both medically, socially and economically, said the specialist.

The definition of sarcopenia dates only from 1989. It is an American physician, Dr. Rosenberg, who appoints and the dramatic loss of muscle mass observed in a large number of people, by analogy with osteopenia.

The main causes of sarcopenia are decreased physical activity, inadequate protein intake (based on a study Clermont, a quarter of the population> 72 years does not meet the recommended nutrient intakes, themselves probably under- estimated), metabolic characteristics of seniors, problems chronic inflammation and subsequent medical stress they may face, quoted Dr. Hébuterne.

The consequences of sarcopenia and undernutrition in the elderly are numerous. Functional at first, since they will cause difficulty walking 400 meters to get up from a chair or an inability to prepare a meal, leading to a vicious circle.

They are also associated with an excess risk of nosocomial infections, as demonstrated by a study conducted at the University Hospital of Nice. While non-malnourished hospitalized patients had a risk of nosocomial infection of 4.43%, the patients suffering from severe malnutrition was 14.6%.

In addition, proteins are necessary for healing: the amino acid muscle catabolism is drawn to meet a physical assault (stress, multiple trauma ...). An older person will have all the more difficult to cope with this stress it is sarcopenia. Moreover, malnutrition is often progressive, initiated by a poorly compensated trauma and maintained by a series of other stressful events successive against which the patient will be more and more difficult to fight.

Another consequence is much more unexpected, increased fat storage in response to lower energy needs, which are associated with various complications such as diabetes and obesity.

It is therefore essential to prevent deficiency of protein intake, to encourage the elderly to maintain regular physical activity people, detect malnutrition by regular weighing and the use of screening tools available to physicians by National Nutrition and Health Plan, and to intervene as soon as possible. Dr. Hébuterne also proposes to conduct screening of sarcopenia at the same time as that of osteopenia.

He noted that epidemiological studies on the prevalence of sarcopenia in France were in progress and that a working group of the High Authority of Health planchait on recommendations for the management of malnutrition globally and not pathology . He also suggested the implementation of work to lead to changes in recommended nutrient intakes.