Validation of Nursing Nutrition Screening Tool in Adult Acute Inpatient Setting

Prevalence and impact of malnutrition on length of stay, readmission, and discharge destination

BACKGROUND

Studies indicate one in three hospitalized patients are malnourished upon admission, however, the documented malnutrition rate in acute care hospitals is often lower. This study measured prevalence of malnutrition upon admission and correlated the relationship among malnutrition status, length of stay (LOS), discharge disposition, and readmission rate.

MATERIALS AND METHODS

A prospective observational cohort study was performed across nine tertiary care hospitals in Houston, Texas. Registered Dietitians screened patients age ≥18 within 24 hours of admission for 2 consecutive days per hospital. Malnourished patients were diagnosed using a modified version of 2012 Consensus Statement from the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition. Data collected included demographics, LOS, discharge disposition, and 30-day re-admission status.

RESULTS

In 416 patients, 31.7% were malnourished upon admission. Malnourished patients were significantly older (67.8 vs 57.6 years, P<.001) and had a lower BMI (26.2 vs 32.4 kg/m² , P<.001) than nonmalnourished patients. Malnourished patients had higher odds of having a LOS ≥3 days (2.38 [95% CI 1.45-3.88], P<.001) and higher odds of readmitting within 30 days (2.28 [95% CI 1.26-4.12], P<.006) when compared to nonmalnourished patients. There were no significantly different clinical outcomes between moderately and severely malnourished groups.

CONCLUSION

The study successfully utilized the modified AND-ASPEN criteria to show that approximately one in three patients presented with malnutrition upon admission. Malnourished patients were more likely to have longer LOS and more likely to be readmitted within 30 days. This article is protected by copyright. All rights reserved.