Sze Mei Yong

Dr Sze Mei Yong is a General Medicine & Clinical Nutrition Physician. She also a Master of Public Health degree, where she majored in Health Program Evaluation and minored in Nutrition Politics and Policy. In addition, Dr Yong is part of the Food and Nutrition Special Interest Group for the Public Health Association of Australia.

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Fasting Trends in the General Medicine Wards: A Pilot Study (FAST PILOT)

Aim:

• Malnutrition is associated with increased risk of complications and prolonged length of stay (Barker, Grout & Crowe, 2011)
• One of the causes of malnutrition is inappropriate or repeated fasting (Misiak et al, 2014)
• At present, there is no data on fasting trends in the General Medicine wards. The aim of this study is to determine to incidence, indication and length of fasting in the General Medicine wards.

 
Methods:

• Prospective audit over 3 months/until target sample size achieved
• Target sample size = 30
• Fasting patients identified at morning Journey Board meetings 
• Eligibility criteria: inpatients of the General Medicine wards age 18 and above who had to fast at least once during their admission
• Data collected from electronic medical records and analysed using Microsoft Excel to produce descriptive statistics
• Commenced 9/7/19, ended 30/8/19 when target sample size reached

 
Results:

• Incidence of fasting = 17.2% (n=31). About 1/3 (n=10) had to fast multiple times
• Main indications for fasting were surgery (51%), cardiac procedures (16%) and imaging (13%)
• 46 fasting episodes altogether. Cancellations occurred in 54.8% 
• Only 26% had documented fasting plans
• Median length of fasting = 12.3 hours (IQR: 5.8). Unknown in 28.2% 
• Median length of stay 7d (IQR: 11.9)

 
Conclusion/clinical practice point:

• Incidence of fasting in General Medicine wards ~17%
• Cancellations occurred in over half of cases. Each fasting episode was about 12 hours long
• Only 1/4 of cases had documented fasting plans
• Results from this study will be used to inform future research/interventions to minimise prolonged/inappropriate fasting

 
References:

1. Barker LA, Gout BS & Crowe TC, 2011. Hospital Malnutrition: Prevalence, Identification and Impact on Patients and the Healthcare System. Int J Environ Res Public Health, 8(2): 514-527 
2. Misiak M, Kruczyk I, Szczepanek K & Klek S, 2014. Severe Undernutrition: Prevalence, Mechanisms, Consequences in Malnutrition. Accessed 8/7/19 at https://lllnutrition.com/mod/url/view.php?id=1431