Prevalence and impact of malnutrition on length of stay, readmission, and discharge destination
Abstract
Background Studies indicate one in three hospitalized patients are malnourished on admission; however, the documented malnutrition rate in acute care hospitals is often lower. This study measured prevalence of malnutrition on admission and correlated the relationship among malnutrition status, length of stay (LOS), discharge disposition, and readmission rate. Methods A prospective observational cohort study was performed across nine tertiary care hospitals in Houston, Texas. Registered dietitians screened patients aged ≥18 years within 24 h of admission for two consecutive days per hospital. Malnourished patients were diagnosed using a modified version of the 2012 Consensus Statement from the Academy of Nutrition and Dietetics (AND)/American Society for Parenteral and Enteral Nutrition (ASPEN). Data collected included demographics, LOS, discharge disposition, and 30-day readmission status. Results In 416 patients, 31.7% were malnourished on admission. Malnourished patients were significantly older (67.8 vs 57.6 years; P Conclusion The study successfully utilized the modified AND-ASPEN criteria to show that approximately one in three patients presented with malnutrition on admission. Malnourished patients were more likely to have a longer LOS and more likely to be readmitted within 30 days.
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In a prospective observational cohort study, Lengfelder et al. showed higher odds for malnourished patients having a length of hospital stay of at least 3 days (OR 2.38, 95% CI 1.45 to 3.88; p<0.001).
“Also, in a prospective observational cohort study, Lengfelder et al. were able to show higher odds for malnourished patients having a LOS of !3 days (2.38, 95% CI, 1.45 to 3.88; p < 0.001) and for readmission within 30 days (2.28, 95% CI, 1.26 to 4.12; p < 0.006) [20].”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [20]
In a prospective observational cohort study, Lengfelder et al. showed higher odds for readmission within 30 days (OR 2.28, 95% CI 1.26 to 4.12; p<0.006).
“Also, in a prospective observational cohort study, Lengfelder et al. were able to show higher odds for malnourished patients having a LOS of !3 days (2.38, 95% CI, 1.45 to 3.88; p < 0.001) and for readmission within 30 days (2.28, 95% CI, 1.26 to 4.12; p < 0.006) [20].”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [20]
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Harris, P. A., Taylor, R., Minor, B. L., Elliott, V., Fernandez, M., O'Neal, L., McLeod, L., Delacqua, G., Delacqua, F., Kirby, J., et al. (2019) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2019.103208 · Cited by 24,013 · see citing works
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ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“3 days (2.38, 95% CI, 1.45 to 3.88; p < 0.001) and for readmission within 30 days (2.28, 95% CI,1.26 to 4.12; p < 0.006) [20].”
Influential
- Authors
- Lengfelder, L., Mahlke, S., Moore, L., Zhang, X., Williams, G., & Lee, J.
- Affiliations
- Memorial Hermann (US)
- The University of Texas Health Science Center at Houston (US)
- Corresponding author
- Lengfelder, Lucy
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2022-02-16
- Volume
- 46
- Issue
- 6
- Pages
- 1335-1342
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- OpenAlex
- W4200081517
- Cited by
- 59
- References
- 1
- Citations by year
- 2026: 16 · 2025: 13 · 2024: 17 · 2023: 9 · 2022: 4
- FWCI
- 4.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- malnutrition, hospitalized patients, malnutrition prevalence, length of hospital stay, hospital readmission, discharge disposition, nutritional screening, body mass index, older adults
- MeSH terms
- Adolescent, Adult, Humans, Length of Stay, Nutritional Status, Patient Discharge, Patient Readmission, Prospective Studies, Nutrition Assessment, Prevalence, Malnutrition
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