Nutritional assessment of hospitalized patients and its impact on morbidity, mortality and length of stay

ABSTRACT

To asses the nutritional status of hospitalized patients in the Internal Medicine Department of Kasr Al-Aini Hospitals and its repercussion on mortality, morbidity and the length of hospital stay. In a prospective way, 177 adult patients admitted to the units of Internal Medicine Department of Kasr Al-Aini Hospitals from December 2004 to March 2006 were evaluated by using the Subjective Global Assessment [SGA]. Patients were followed to determine length of hospital stay, complications and in-hospital mortality. The sample consisted of 100 men and 77 women. The mean age was 53 year, with a standard deviation of 14 years, with 33.9% of patients [n=60] were over 60 years. Most patients, 74% [n=131], were from rural areas. A total of 87.6% of patients [n=155] were admitted to general wards and 12.4% [n=22] to the ICU. According to the SGA, 41.8%] [n=74] of patients had moderate malnutrition or were at risk of malnutrition and there were no severely malnourished patients. Men were at increased risk of being malnourished compared with women [p<0.05]. A tendency to malnutrition was observed in older individuals, especially in those 60 years and older [p<0.001]. According to univariate analysis, complications were significantly more frequent among those at risk of malnutrition than among the well nourished as there was 61 patients from group 2 [82.4%] versus 32% [n=33] incidence of complication in group 1 [p>0.001, Relative Risk RR=2.58 and Attributable Risk AR=50.4%]. Overall mortality was 15.3% [n=27] of which 11.9% belonged to group 2 [n=21] and only 3.4% [n=6] belonged to group 1 [p<0.001] and the median length of hospital stay was 19 days [range 6-39 days]. The hospital stay in group 2 was 25 days +/- 14 [Mean +/- SD] Vs 14 days +/- 8 [Mean +/- SD] in group 1 [p<0.001]. Malnutrition is frequent in hospitalized patients in Internal Medicine department on admission, and it is an independent risk factor for morbidity, mortality, and prolongs the length of hospitalization. Efforts should be made to quickly assess the nutritional status of these patients and early start of nutritional intervention should be done