Clinical and economic outcomes associated with malnutrition in hospitalized patients
Ruiz, Álvaro J. | 2019
Background & aims: Hospitalized patients show a high rate of malnutrition, which is associated with
poor patient outcomes and high healthcare costs. However, relatively few studies have investigated the
association between clinical and economic outcomes and malnutrition in hospitalized patients, particularly those with cardiac and pulmonary conditions.
Methods: This multicenter prospective observational cohort study included 800 patients hospitalized at
four Colombian hospitals with a diagnosis of congestive heart failure, acute myocardial infarction,
community-acquired pneumonia, or chronic obstructive pulmonary disease. All patients were screened
for malnutrition using the Malnutrition Screening Tool (MST). A descriptive analysis of baseline variables
was followed by multivariate analysis and inverse probability weighting (IPW) to compare the clinical
outcomes, i.e., length of stay (LOS), mortality, and readmission, and hospital costs associated with a
positive MST result.
Results: The prevalence of a positive MST result was 24.62% (n ¼ 197) and was more common in patients
with older age and greater comorbidities. Multivariate analysis controlling for age, gender, healthcare
plan, university degree, hospitalization, entrance disease and Charlson co-morbidity index showed that a
positive MST result was associated with increased LOS (1.43 ± 0.61 days) and both in-hospital mortality
(odds ratio, 2.39) and global mortality (odds ratio, 2.52). IPW analysis confirmed the association between
a positive MST result and increased hospital LOS and 30-day mortality, as well as a relative increase of
30.13% in the average cost associated with hospitalization.
Conclusions: This study of hospital inpatients demonstrated a high burden of malnutrition at the time of
hospital admission, which negatively impacted LOS and mortality and increased the costs of hospitalization. These findings underscore the need for improved diagnosis and treatment of hospital malnutrition to improve patient outcomes and reduce healthcare costs.