The effect of malnutrition at admission on length of hospital stay among adult patients in developing country: A prospective cohort study.

Abstract

Malnutrition in hospitalized adults is a highly prevalent problem. During hospital admission, nutritional care and nutritional screenings are often overlooked components of the health care facilities in developing countries. Identifying patients who are at risk of malnutrition at admission are vital to ameliorate clinical outcomes. Therefore, the present study was aimed at assessing the magnitude of hospital malnutrition at the time of admission and evaluates its effect on the length of hospital stay among adult patients. We conducted a prospective cohort study in patients ≥18 years admitted in Tikur Anbessa Specialized hospital in Ethiopia. At admission, patient's nutritional status was assessed within 48h using the Subjective Global Assessment (SGA). The main clinical outcome, length of stay in hospital (LOS) was captured for patients in days. We ran a multivariate Cox's regression analysis to determine the relationship between malnutrition at admission and its effect on LOS. Four hundred seventeen patients were enrolled. Based on Subjective Global Assessment (SGA), 62.1% were malnourished. The mean (SD) length of hospital stay for all patients admitted was 13.84 days±7.53, with a significant difference (p < 0.01) in length of stay between malnourished patients and well-nourished patients. Malnourished patients had significantly longer hospital stays (17.2±6.8 days) than well-nourished patients (8.3±4.9 days) during 30 days observations. The multivariate Cox's regression model controlled for age, sex, living conditions, number of medications, and number of diagnostic categories, disease severity score, number of comorbidities and presence of cancer found that malnutrition at admission was independently associated with prolonged LOS (adjusted hazard ratio (AHR), 0.29; 95% CI, 0.22,0.38). Malnutrition at admission was highly prevalent and was highly associated with prolonged length of hospital stay. Therefore, it is essential to assess the nutritional status of patients early in admission and to institute appropriate nutritional therapy.