Proactive screening in Israel identifies alarming prevalence of malnutrition among hospitalized patients--action is needed

Abstract

Objective: Malnourished patients suffer from higher morbidity and mortality rates than well-nourished patients do. However, few studies have controlled the outcomes for the underlying illnesses. Our aim was to determine the prevalence of malnutrition among patients admitted to the internal medicine ward and to determine whether malnutrition is an independent risk factor for adverse outcomes in these settings.

Methods: Consecutive patients screened for malnutrition with the MUST (Malnutrition Universal Screening Tool), admitted to an internal medicine department, were included in this study. Demographic data, background disease, laboratory results, length of stay, and mortality rates were retrieved from the computerized file and Charlson Comorbidity Index (CCI) was calculated. Univariate and multivariate analyses were used to check for the association of malnutrition and outcome measures.

Results: One thousand consecutive patients were included in the study. Mean age was 67.6 y; 25.4% of patients were found to be at high risk for malnutrition. Patients at high risk for malnutrition had significantly longer length of stay and mortality rates than well-nourished patients (9.7 d versus 6.2 d and 19.3% versus 3.2%; accordingly [P < 0.001]). On multivariate analyses, increased mortality was found to be associated with a high risk for malnutrition as well as pneumonia, acute myocardial infarction, acute renal failure, or shock on admission and a high CCI score.

Conclusion: The prevalence of malnutrition among hospitalized patients, as measured by the MUST score, is common. Malnutrition is prevalent and represents an independent and significant risk factor for in-hospital mortality and increased length of stay in patients admitted to the internal medicine ward.