Prevalence and impact of malnutrition on length of stay, readmission, and discharge destination.

Abstract

Studies indicate one in three hospitalized patients are malnourished on admission; however, the documented malnutrition rate in acute care hospitals is often lower. This study measured prevalence of malnutrition on admission and correlated the relationship among malnutrition status, length of stay (LOS), discharge disposition, and readmission rate. A prospective observational cohort study was performed across nine tertiary care hospitals in Houston, Texas. Registered dietitians screened patients aged ≥18 years within 24 h of admission for two consecutive days per hospital. Malnourished patients were diagnosed using a modified version of the 2012 Consensus Statement from the Academy of Nutrition and Dietetics (AND)/American Society for Parenteral and Enteral Nutrition (ASPEN). Data collected included demographics, LOS, discharge disposition, and 30-day readmission status. In 416 patients, 31.7% were malnourished on admission. Malnourished patients were significantly older (67.8 vs 57.6 years; P < 0.001) and had a lower body mass index (26.2 vs 32.4; P < 0.001) than nonmalnourished patients. Malnourished patients had higher odds of having a LOS of ≥3 days (2.38 [95% CI, 1.45 to 3.88]; P < 0.001) and higher odds of readmitting within 30 days (2.28 [95% CI, 1.26 to 4.12]; P < 0.006) when compared with nonmalnourished patients. There were no significantly different clinical outcomes between moderately and severely malnourished groups. The study successfully utilized the modified AND-ASPEN criteria to show that approximately one in three patients presented with malnutrition on admission. Malnourished patients were more likely to have a longer LOS and more likely to be readmitted within 30 days.