Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: results from the Nutrition Care Day Survey 2010

Abstract

Background & aims: The Australasian Nutrition Care Day Survey (ANCDS) ascertained if malnutrition and poor food intake are independent risk factors for health-related outcomes in Australian and New Zealand hospital patients.

Methods: Phase 1 recorded nutritional status (Subjective Global Assessment) and 24-h food intake (0, 25, 50, 75, 100% intake). Outcomes data (Phase 2) were collected 90-days post-Phase 1 and included length of hospital stay (LOS), readmissions and in-hospital mortality.

Results: Of 3122 participants (47% females, 65 ± 18 years) from 56 hospitals, 32% were malnourished and 23% consumed ≤ 25% of the offered food. Malnourished patients had greater median LOS (15 days vs. 10 days, p < 0.0001) and readmissions rates (36% vs. 30%, p = 0.001). Median LOS for patients consuming ≤ 25% of the food was higher than those consuming ≤ 50% (13 vs. 11 days, p < 0.0001). The odds of 90-day in-hospital mortality were twice greater for malnourished patients (CI: 1.09-3.34, p = 0.023) and those consuming ≤ 25% of the offered food (CI: 1.13-3.51, p = 0.017), respectively.

Conclusion: The ANCDS establishes that malnutrition and poor food intake are independently associated with in-hospital mortality in the Australian and New Zealand acute care setting.

Keywords: ANCDS; ARDRG; Australasian Nutrition Care Day Survey; Australian Refined Diagnosis Related Group; BMI; Body Mass Index; CI; Confidence Interval; DRG; Diagnosis Related Group; Disease type and severity; EQ-5D visual analogue scale; EQ-5Dvas; In-hospital mortality; LOS; Length of stay; MAJOR Diagnostic Category; MDC; MST; Malnutrition; Malnutrition Screening Tool; PCCL; Patient Clinical Complexity Level; Poor food intake; Readmissions; SGA; Subjective Global Assessment; length of stay.