Nutrients, Vol. 17, Pages 3041: An 11-Year Retrospective Analysis of the Prevalence of Malnutrition Diagnosis at Discharge in a Multi-Site Hospital: The Impact of Introducing a Clinical Nutrition Service
Nutrients doi: 10.3390/nu17193041
Authors:
Giorgia Preatoni
Dario Bertolotti
Giulia Galligani
Nicola Ossola
Massimo Quarenghi
Background: Nutritional therapy improves prognosis by reducing morbidity and mortality in malnourished hospitalised patients. To determine the occurrence of hospital malnutrition, it is essential to verify healthcare organisations’ ability to identify at-risk patients, considering that malnutrition is often hard to recognise without adequate screening. Methods: The aim of this study is to analyse the temporal evolution in hospitalised patients’ malnutrition, documented as diagnosis discharge letters, over an 11-year period (2014–2024) in four acute care hospitals, with a combined mean of 38,000 inpatients per year. Binomial regression and interrupted time series analysis were used to evaluate temporal evolution in the identification of malnutrition, particularly in relation to the introduction of a nutritional service in 2017. Results: Malnutrition diagnoses increased steadily across hospitals and within internal medicine and surgery departments. Interrupted time series analysis showed a significant rise in diagnostic odds post-intervention, especially in internal medicine. A plateau was observed in the last 3 years, with a mean prevalence of malnutrition of 18.2% for internal medicine (95% CI: 13.6–22.9) and 4.1% for surgery (95% CI: 0.5–7.6). Without the nutritional service, these results likely only would have been reached by 2031 in internal medicine and 2024 in surgery, suggesting an advancement of about eight years in medical wards. Conclusions: The introduction of a nutritional team has probably accelerated and improved the ability to quickly identify and therefore treat malnourished inpatients.
Background: Nutritional therapy improves prognosis by reducing morbidity and mortality in malnourished hospitalised patients. To determine the occurrence of hospital malnutrition, it is essential to verify healthcare organisations’ ability to identify at-risk patients, considering that malnutrition is often hard to recognise without adequate screening. Methods: The aim of this study is to analyse the temporal evolution in hospitalised patients’ malnutrition, documented as diagnosis discharge letters, over an 11-year period (2014–2024) in four acute care hospitals, with a combined mean of 38,000 inpatients per year. Binomial regression and interrupted time series analysis were used to evaluate temporal evolution in the identification of malnutrition, particularly in relation to the introduction of a nutritional service in 2017. Results: Malnutrition diagnoses increased steadily across hospitals and within internal medicine and surgery departments. Interrupted time series analysis showed a significant rise in diagnostic odds post-intervention, especially in internal medicine. A plateau was observed in the last 3 years, with a mean prevalence of malnutrition of 18.2% for internal medicine (95% CI: 13.6–22.9) and 4.1% for surgery (95% CI: 0.5–7.6). Without the nutritional service, these results likely only would have been reached by 2031 in internal medicine and 2024 in surgery, suggesting an advancement of about eight years in medical wards. Conclusions: The introduction of a nutritional team has probably accelerated and improved the ability to quickly identify and therefore treat malnourished inpatients. Read More