ObjectiveThis study aimed to investigate the association between nutritional appetite status-assessed during a standardized eight-week hospitalization period using the Simplified Nutritional Appetite Questionnaire (SNAQ)-and discharge outcomes at a one-year follow-up in older hospitalized patients with multiple comorbidities.MethodsA prospective one-year observational study was conducted in a convalescent geriatric hospital. This study was conducted with 77 patients aged 65 and older with comorbidities who have been on oral intake for more than 8 weeks after hospitalization. Patients were divided into low ( = 40) and normal ( = 37) appetite groups based on a SNAQ score cut-off of 14. Odds ratio (OR) analysis was conducted to compare improved and deteriorated discharge outcomes at the one-year mark according to appetite status, adjusted for Charlson comorbidity index, activities of daily living score, and nutritional intake.ResultsThe low appetite group had significantly lower energy (1215.68 ± 68.96 kcal vs. 1495.50 ± 48.03 kcal,  = 0.001) and protein intake (55.66 ± 2.83 g vs. 65.75 ± 1.88 g,  = 0.004). They reported poorer appetite, felt full with fewer mouthfuls, worse food taste, and fewer meals daily ( < 0.05). Adjusted for Charlson comorbidity index, Activities of daily living score, and nutritional intake, the low appetite group had a higher risk of adverse discharge outcomes, such as death or intensive care, with an adjusted OR of 8.524 (95% CI: 1.331-59.739,  = 0.024). Their likelihood of improvement, defined as discharge to a nursing home or home, was reduced, with an adjusted OR of 0.109 (95% CI: 0.013-0.915,  = 0.041).ConclusionsThis study underscores the clinical importance of assessing and promoting appetite to improve discharge outcomes and reduce healthcare costs for long-term hospitalized geriatric patients.