ABSTRACT
OBJECTIVE: This study aimed to compare cost and length of hospital stay of malnourished and well-nourished surgical patients. METHODS: A total of 6821 surgical patients were enrolled from January to December 2014 and were divided into 11 groups according to their disease diagnosis: soft tissue; upper gastrointestinal tract; colorectal; hepato-pancreato-biliary; vascular; head-neck breast; urology; cardio-vascular-thoracic surgery; neurology; plastic surgery; and trauma. The patients in each group were categorized as having either malignant or benign disease. All patients received nutritional screening and subjective global assessment, and details of length of hospital stay and cost were collected and analyzed. RESULTS: There were 4052 benign and 2769 malignant cases. In the benign category, patients with malnutrition in all subdivisions had longer hospital stays than those who were well-nourished. Significantly longer hospital stay was found in hepato-pancreato-biliary, neurology and cardio-vascular-thoracic surgery (p < 0.01, p = 0.01, p < 0.001). Hospital cost was also higher in malnourished patients in all subdivisions, and the differences were significant in the hepato-pancreato-biliary, upper gastrointestinal tract, colorectal, soft tissue, urology and head-neck-breast groups (p < 0.001, p = 0.01, p = 0.01, p = 0.03, p < 0.01, p < 0.01). In the malignant category, patients in all groups with malnutrition had longer hospital stay than those who were well nourished. Significantly longer hospital stay was found in the hepato-pancreato-biliary, upper gastrointestinal tract, colorectal, urology and neurology groups (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001). Hospital cost was also higher with malnourished patients in all groups and significant differences were found in the hepato-pancreato-biliary, upper gastrointestinal tract, colorectal, urology, head-neck-breast and cardio-vascular-thoracic surgery groups (p < 0.001, p < 0.001, p < 0.001, p < 0.01, p < 0.01, and p = 0.02). CONCLUSION: Malnourished patients, both with benign and malignant disease, incurred higher costs and had longer hospital stays.
