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Malnutrition increases hospital mortality risk

One in three patients hospitalized in the U.S. is at risk for malnutrition, and diminished meal intake also increases mortality risk, according to study findings published in the Journal of Parenteral and Enteral Nutrition.

“Research shows that patients’ food intake is often compromised during hospitalization and that nutrition status subsequently deteriorates,” Abby C. Sauer, MPH, RD, of Abbott, and colleagues wrote. “Although the association between hospital food intake and patient outcome is well established in countries outside the U.S., no such data currently exist for the U.S.”

To both assess the prevalence of malnutrition risk and determine the impact of hospital food intake on 30-day in-hospital mortality, researchers used the nutritionDay database to identify 9,959 patients aged older than 18 years (mean age, 64 years; 53% women) who were admitted to an ICU between 2009 and 2015.

Patients responded to nutrition-related survey questions which researchers subsequently mapped to the Malnutrition Screening Tool. If patient-responses mapped to a score of two or higher, researchers considered them at risk for malnutrition.

Patients also recorded meal intake on a questionnaire, specifying whether they ate all, half, a quarter or none of their food.

Researchers found that 32.7% of patients included in the study were at risk for malnutrition. The risk was highest in infectious disease (46.1%) and long-term care (45.8%) and lowest in orthopedic surgery (23.7%) wards.

In addition, they found that more than half of patients did not eat their entire lunch and/or dinner, with 36.5% eating the entire meal, 25.8% eating half their meal and 25.2% eating a quarter of their meal or nothing.

 

One in three patients hospitalized in the U.S. is at risk for malnutrition, and diminished meal intake also increases mortality risk.

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Finally, researchers observed that patients who ate a quarter of their meal had a mortality HR of 3.24 (95% CI, 1.73-6.07) compared with those who ate all their meal. In addition, for patients who were allowed to consume food but ate nothing, the mortality HR increased to 5.99 (95% CI, 3.03-11.84).

Patients who were not allowed to eat had a mortality HR of 4.38 (95% CI, 2-9.58).

“This rate of malnutrition risk shows that hospital malnutrition remains a problem in U.S. hospital patients,” the researchers wrote. “In addition, the data demonstrate that patients who have diminished intake experience increased mortality risk and do not always receive optimal nutrition intervention. These results highlight the ongoing issues of poor oral intake and malnutrition risk in the hospital setting and the need for optimal nutrition care to improve outcomes, including mortality.” – by Melissa J. Webb

Disclosures: Sauer reports being an employee and stockholder for Abbott Nutrition. Please see the study for all other authors’ relevant financial disclosures.