Clinical and financial implications of disease-related malnutrition in a department of Internal Medicine: Prospective cohort study

• Published in: Revista clínica espanõla (English edition) 2016-12, Vol.216 (9), p.468-473
• Main Authors: Ballesteros-Pomar, M.D., Calleja-Fernández, A., González-Valdés, M., Pintor-de la Maza, B., Villar Taibo, R., Vidal-Casariego, A., Urioste-Fondo, A., Torres-Torres, B., de Luis-Román, D., Cano-Rodríguez, I.
• Format: Article
• Language: English
• Subjects: Costes sanitarios; Desnutrición relacionada con la enfermedad; Disease-related malnutrition; Healthcare costs; Nutritional support; Soporte nutricional
• ISSN: 2254-8874; 2254-8874
• DOI: 10.1016/j.rceng.2016.07.001

Disease-related malnutrition is a challenge for Spanish hospitals. Our objective was to assess the feasibility and importance of establishing a nutritional screening strategy in our community. A prospective cohort study was conducted in a department of internal medicine for 3 months. The nutritional screening was conducted at admission and was repeated weekly using the Malnutrition Universal Screening Tool. We analysed the clinical data, mean stay and expenses. The study included 330 patients (53.9% men), with a mean age of 77.8 years. The mean stay was 7 days, and the Charlson comorbidity index was 5.4. At admission, the Malnutrition Universal Screening Tool detected 26.9% of patients with a risk of malnutrition. Eighteen percent of the patients with a good nutritional state developed malnutrition during the hospitalisation. The patients with initially severe malnutrition had a longer mean stay. The patients whose nutritional state worsened during the hospitalisation had a significantly longer stay (2.5 days) compared with those whose state did not worsen. These cases of malnutrition caused a cost overrun of €767 per hospitalisation (35% greater), which entailed a malnutrition-related excess expenditure of €646,419.93 annually in the studied department. The appropriate coding resulted in an increase in mean weight from 2.11 to 2.81, which represented €82,568.52 and has not been previously quantified. The high prevalence and clinical and financial implications of disease-related malnutrition in patients hospitalised in internal medicine warrants establishing protocols for its early detection and treatment. La desnutrición relacionada con la enfermedad es un reto en nuestros hospitales. Nuestro objetivo fue valorar la factibilidad e importancia de establecer una estrategia de cribado nutricional en nuestro medio. Estudio de cohortes prospectivo en un servicio de Medicina Interna durante 3 meses. El cribado nutricional se realizó al ingreso y se repitió semanalmente mediante la herramienta Malnutrition Universal Screening Tool. Se analizaron los datos clínicos, la estancia media y los gastos. Se incluyeron 330 pacientes (53,9% varones), con una edad media de 77,8 años; la estancia mediana fue de 7 días, y el índice de comorbilidad de Charlson de 5,4. La herramienta Malnutrition Universal Screening Tool detectó al ingreso un 26,9% de pacientes con riesgo de desnutrición. Un 18% de pacientes con buen estado nutricional desarrollaron desnutrición durante la hos