Browsing by Author "Yakob Desalegn"

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    Assessment of Change in Nutritional Status and its Clinical Outcomes among Adult Patients in Mizan-Tepi University Teaching Hospital Southwest Ethiopia: A Prospective Cohort Study
    (Addis Abeba University, 2020-11) Addisu Yigezu; Bilal Shikur; Yakob Desalegn
    Background: Large proportions of patients in the hospital are malnourished. Around 30% to 50% of patients show the risk of malnutrition at admission and many of these patients experience further nutritional decline during a hospital stay. Malnutrition among hospitalized patients has strong clinical effects that are reflected by an increased risk of medical complications, increased length of stay and poor quality of life among adult patients. Objective: To examine the patterns of nutritional status over time in adult patients and its association with the occurrence of complication and length of stay in hospital in Mizan-Tepi University Teaching Hospital Southwest, Ethiopia 2020. Methods: Hospital-based prospective observational study involving 258 medical, surgical, and gynecologic wards admitted adult patients, aged from 18-64 years was conducted in Mizan-Tepi University teaching hospital from March 1, 2020 – May 30, 2020. Patient’s nutritional status was assessed within 24 h using the Subjective Global Assessment (SGA) at admission and before discharge. Chi-square and student t-test was used to identify the statistical difference between groups of nutrition change category and outcome variables. Logistic regression models were used to identify the predictors of decline nutritional status. Statistical significance of 0.05 was used in all hypothesis tests. Results: On admission, a total of 258 patients were included, of these 166 patients had stayed greater than five days in the hospital and measured both subjective global assessment (SGA) at admission and discharge. The majority of participants were (66.9%) female. the median age was 45. The median length of stay in the study population was 10 days (8, 12). Around 75% were malnourished at admission (SGA B/C) and 61% were malnourished at discharge. Overall 31% (n=52) improved, and 19% (n=31) declined nutritionally from admission to discharge. Odds of occurrence of complications were significantly greater (OR=2.274, 95%CI, 1.052, 4.915) longer length of stay (12 days) for declined in nutritionally as compared and well-nourished patients. Conclusions: In our study, 19% of patients declined their nutritional status during hospitalization. Indicating a need to monitor nutritional status before discharge and implementation of appropriate nutrition interventions to improve patients’ clinical outcomes is mandatory in a clinical setting.
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    The Effect of Malnutrition at Admission on Length of Hospital Stay among Adult Patients in Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia: A Cohort Study
    (Addis Abeba University, 2019-10) Yakob Desalegn; Bilal Shikur; Seifu Hagos
    Background: Malnutrition in hospitalized adults is a highly prevalent problem. The worldwide prevalence of malnutrition in hospitals ranges from 15–54%. Hospital malnutrition is associated with delays in recovering from illness, increased cost of care, complications, increased the length of stay, mortality and poor quality of life compared to well-nourished patients. In hospitals, length of stay (LOS) is a priority concern but it may be prolonged by malnutrition through its effect on immune functions, wound healing process and greater risk of complications. Amidst the high rates of malnutrition documented worldwide and its associated consequences, little is known on clinical adverse outcomes like prolonged length of hospital stay in the Ethiopian hospital setting. Objective: The study aimed to evaluate the effect of malnutrition at the time of admission on the length of hospital stay among adult patients in Tikur Anbessa Specialized Hospital, Ethiopia Method: A prospective cohort study was conducted among hospitalized adult patients, who were admitted to Tikur Anbessa specialized hospital medical or surgical wards ,with a minimum length of stay of 24 hours were recruited. Proportional allocation and Consecutive sampling method were used to select patients. At admission, Patients Nutritional status were assessed within 48 h using the Subjective Global Assessment (SGA).The main clinical outcome Length of stay in hospital (LOS) was captured for every patient in days. Socio demographic, economic and admission related Patient clinical Characteristics were included. Data were compiled, checked, coded ,entered and cleaned using Epi Data 4.4.1 and all statistical tests were done using STAT version 15.1 software. Descriptive statistical tests and multivariate Cox’s regression model was used to investigate the effect of malnutrition on the length of hospital stay after adjusted for several potential nutritional and clinical confounders recorded at admission. Results are expressed as hazard ratios (HR) and their 95% CI. Result: On admission a total of 417 patients , predominantly male (54.2%), were included. The mean age was 38 ± 16 years. Using Subjective Global Assessment (SGA), the magnitude of malnutrition was 62.1%(95% CI: 57.3%, 66.6%) . The mean length of stay was 13.84 days ± 7.53SD, with a significant difference (p<0.01) in length of stay between malnourished patients and well-nourished patients. Malnourished patients had longer hospital stays (17.2± 6.8 days vs. 8.3±4.9 days, p< 0.001).The final multivariate model, which was controlled for age, sex, living conditions, number of medications, and number of diagnostic categories, disease severity score, number of comorbidities and presence of cancer showed that malnutrition (SGA B+C) at admission was independently associated with prolonged LOS (HR, 0.29; 95% CI, 0.22–0.38) Conclusion: The study showed that malnutrition was highly prevalent among hospitalized adult patients and was associated with increased length of stay. The rate of malnutrition tended to be high when the patient was older than 60 years old . Malnourished patients needed longer hospitalization in the present study. More attention should be paid to nutrition in both medical and surgical patients. Therefore, it’s essential to assess the nutritional status of patients early in admission and to institute appropriate nutritional therapy to minimize its devastating consequences on the patients and health care system.
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    The Relationship between Nutritional Status and Quality of Life among Breast Cancer Patients in Ethiopia Treated at Tikur Anbessa Specialized Hospital and Saint Paul Millennium Medical College
    (Addis Abeba University, 2020-12) Ruth Adam; Samson Gebremedin; Yakob Desalegn
    Background: Breast Cancer patients often suffer from a substantial loss in weight and energy as a result of changes in appetite and metabolism. The prevalence of malnutrition in breast cancer patients ranges from 30% to 60%. While it is already a proven fact that malnutrition is prevalent among cancer patients, the relationship between nutritional status and quality of life among (QoL) in breast cancer patients had not been adequately explored. Objectives: This study is conducted to determine the association between nutritional status and quality of life of Breast Cancer patients at Tikur Anbessa Specialized Hospital (TASH) and St. Paul’s Hospital Millennium Medical College (SPMMC), Addis Ababa, 2020. Methods: A cross-sectional study on breast cancer patients treated at Tikur Anbessa specialized hospital (TASH) and St. Paul millennium medical college (SPHMMC) oncology centres outpatient and in-patient departments was done from May to August 2020 . Consecutive sampling was used to select study participants. Nutritional status was assessed using subjective global assessment (SGA) screening tool. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality o fLife Questionnaire Cancer 30 (EORTC QLQ C30 a quality of life measurement scale for cancer patients. To determine the relationship between quality of life scores and nutritional status multivariable linear regression was used. Results: A total of 411 consecutive breast cancer patients were included. A high prevalence of moderate (30.9%) and severe (25.7%) malnutrition was observed. Regarding the quality of life scores of these patients: The mean of overall quality of life of the study participants was (M=61.33 (SD=20.83)). Among the functional scale domains; the first domain with the highest mean score was cognitive functioning (M=76.85 (SD=26.87)). The lowest mean among functional scales was observed in social functioning (M=55.03 (SD=36.26)). The domain with the highest mean among the symptom scales was fatigue (M=48.98 (SD=29.03)) The lowest mean scores were observed in Nausea and vomiting (M=21.65 (SD=31.60)). Moderate and severe malnutrition were negatively associated with overall quality of life β = −9.21 CI (−14.59, −4.67) and β = −17.81 CI (−16.6, −2.91) respectively. Malnutrition also showed negative associations with all domains of functional status and strong positive associations with symptom scores covered in the EORTC QLQ C-30. Conclusion: This study revealed that the magnitude of malnutrition in the breast cancer population is very large and the comptonization of their nutritional status also playes a significant role in decreasing their quality of life. .