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Disease-related malnutrition in hospitalized chronic patients with complex needs

Burgos, R., Joaquín, C., Blay, C., Vaqué, C.
Clinical nutrition 2019
body mass index, gender, hospitals, malnutrition, mortality, nutrition assessment, nutrition risk assessment, patients, women, Spain
Disease-related malnutrition is a prevalent condition that can be associated with multimorbidity. The purposes of this study were to assess the prevalence of disease-related malnutrition in a cohort of chronic patients with complex needs (CPCN) admitted to two University hospitals, and to evaluate the impact of malnutrition in their hospitalization outcomes.All CPCN admitted on a previously agreed day in non-critical services of two University hospitals in Catalonia were included. Nutritional risk was evaluated with Mini-Nutritional Assessment Tool and Nutritional Risk Screening 2002. Hospitalization outcome data were evaluated, including length of the hospital stay, mortality during admission and placement when discharged. After five months, a new evaluation was performed to assess mortality and readmissions.A total of 101 patients were included, 83% of which were at nutritional risk when screened with NRS-2002; when using MNA, 86% of them were found to be either at nutritional risk or malnourished. Malnourished patients had a greater need for home care/intermediate care hospital at discharge (41.8% vs 22.9%, p < 0.01), and a higher mortality rate during admission (16.7% vs 1.6%, p < 0.01). Mortality at 5 months was also higher in the malnourished group (30.5% vs 9.8%, p < 0.01). Factors associated with malnutrition were BMI and gender (malnutrition was more prevalent in women). In our cohort, malnutrition was the sole independent predictor of mortality at 5 months.The prevalence of both malnutrition and risk of malnutrition is very high in hospital-admitted CPCN, and has a profound impact on placement at discharge and mortality. This high prevalence is not explained by the multimorbidity pattern. Other factors need to be evaluated in this group of high-need, high-cost patients.