de Luis Daniel, Lopez Guzman Antonio
Instituto de Endocrinologia y Nutricion Clinica, Facultad de Medicina, Spain; Grupo de Nutricion, Sociedad Castellano Leonesa de Endocrinologia, Diabetes y Nutricion, Spain.
Eur J Intern Med. 2006 Dec;17(8):556-60. doi: 10.1016/j.ejim.2006.02.030.
Studies from different hospitals confirm the high prevalence of malnutrition among inpatients. In the present multi-center study, we evaluated the prevalence of malnutrition and the relationship of different nutritional markers to length of hospital stay and mortality.
A randomized population of 213 hospitalized patients (112 males and 101 females) from nine hospitals were included in the study. The nutritional status of the patients was assessed by nutrition specialists in each nutrition unit.
The mean age of the patients was 73.5+/-15 years. Their mean weight was 63.5+/-14.5 kg, BMI 25.9+/-6.1, and weight loss in the previous 3 months 4.2+/-6.6 kg. The mean length of hospital stay was 19.6+/-62.5 days. The prevalence of malnutrition, assessed by means of a mini-nutritional assessment (MNA) test, was 23.9% (score under 17 points), and 50.2% of the patients were at risk of malnutrition (score between 17 and 23.5). An analysis correlating length of hospital stay (LOS) and predictive parameters in the entire group showed a positive association with MNA score (r=-0.23; p<0.05). In multivariate analysis with LOS (days) as dependent variable and albumin, weight loss, weight, and MNA score as independent variables, after adjusting for age and sex, only weight loss and MNA score remained independent predictors in the model (F=4.6; p<0.05). There was an increase of 2.6 days in LOS (95% CI: 0.7-4.5) for each decrease of 1 kg, and a decrease of 3.2 days (95% CI: -5.6-0.6) for each increase of 1 point in MNA score. In a survival analysis, an independent factor that decreased mortality was MNA score (hazard ratio: 0.79; 95% CI: 0.66-0.94), after adjusting for age and sex.
Hospitalized patients have a high prevalence of malnutrition. Patients with a low MNA score and previous weight loss have a longer LOS. Mortality decreases with each point of increase in MNA score.
