Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES Study

Abstract

Background and aims: The main objective of the PREDyCES study was twofold. First, to analyse the prevalence of hospital malnutrition in Spain, both at admission and at discharge, and second, to estimate the hospital costs associated with disease-related malnutrition.

Methods: The study was a nationwide, cross-sectional, observational, multicentre study in routine clinical practice, which assessed the prevalence of hospital malnutrition both at patient admission and discharge using NRS-2002. A study extension analysed the incidence of complications associated with malnutrition, excess hospital stay and healthcare costs associated with hospital malnutrition.

Results: Malnutrition was observed in 23.7% of patients according to NRS-2002. Multivariate analysis revealed that age, gender, presence of malignant disease, diabetes mellitus, dysphagia and polymedication were the main factors associated with the presence of malnutrition. Malnutrition was associated with an increase in length of hospital stay, especially in patients admitted without malnutrition but who presented malnutrition at discharge (15.2 vs. 8.0 days, p < 0.001), with an associated additional cost of €5,829 per patient.

Conclusion: In Spanish hospitals, almost one in four patients is malnourished. This condition is associated with increased length of hospital stay and associated costs, especially in patients developing malnutrition during hospitalization. Systematic screening for malnutrition should be generalised in order to implement nutritional interventions with well-known effectiveness.