Impact of diabetes, malnutrition and sarcopenia on the prognosis of patients admitted to internal medicine

Abstract

ObjectiveTo describe patients hospitalized in internal medicine in terms of malnutrition and sarcopenia, depending on the presence or absence of type 2 diabetes mellitus (DM2), as well as to evaluate short- and long-term mortality related to both. MethodsCross-sectional, single-center study, which included consecutive patients admitted to internal medicine in May and October 2021. Malnutrition was determined using the Mini Nutritional Assessment-Short Form (MNA-SF) and sarcopenia using SARC-F and handgrip strength. Patients hospitalized for more than 48 h are excluded. Results511 patients were analyzed, 49.1% male, mean age 75.2 +/− 15 years, 210 (41.1%) DM2. 6 groups (2 × 3 design) are generated based on the presence of DM2 and the nutritional status according to the result of the MNA-SF: 12–14 points, without risk; MNA-SF 8–12 points, high risk; MNA-SF 0–7 points, malnourished. Malnourished patients with DM2 had significantly higher sarcopenia, comorbidity, inflammation, and pressure ulcers. The main determinants of in-hospital mortality were sarcopenia (OR 1.27, 95%CI 1.06–1.54, p = 0.01), comorbidity (OR 1.27, 95%CI 1,08−1,49, p = 0.003) and inflammation (OR 1.01, 95%CI 1.00–1.02, p = 0.02). The 120-day prognosis was worse among malnourished patients (p = 0.042). ConclusionPatients admitted with DM2 have a similar degree of malnutrition than the rest, but with greater sarcopenia. This sarcopenia, together with inflammation and comorbidity determine a worse prognosis. The active and early identification of malnutrition and sarcopenia and their subsequent approach could improve the prognosis of patients.