Amongst patients with CVD there is strong acknowledgement that the cardioprotective diet plays an important role in long-term care(1). The prevalence of malnutrition amongst patients with CVD is, however, not widely recognised.
The present audit reviewed all inpatients on cardiac wards on dietetic referrals over 1 year. A total of 194 patients were included (120 males and seventy-four females; mean age 68 (range 16–90) years). Nutritional status, anthropometry, reason for referral, length of time under the care of the dietitian and follow-up requirements were recorded.
Table 1. Referral to dietitian according to cardiac operation
Table 2. Anthropometric measurements undertaken
Nutritional support intervention was given to 149 patients (77%); 100 (52%) of patients required oral nutrition support and forty-nine (25%) required enteral feeding. Healthy eating advice was given to fourteen (7%) patients. Over one-third of patients were weight losing and 20% were malnourished using the National Institute for Health and Clinical Excellence criteria(2). The majority of patients (ninety-one; 47%) were under dietetic management for <10 d, thirty-four (18%) were seen for >1 month and fifty-three (29%) patients required continued dietetic support on discharge.
The number of patients referred to the dietitian for nutritional support was higher than the ward expected, although malnutrition in patients on medical and surgical cardiac wards was potentially underestimated given the amount of total clinical activity. This audit demonstrates that healthy eating advice is not always the priority for patients on cardiac wards. The malnutrition universal screening tool has now been implemented to help identify all patients who require nutritional support intervention(3).
