Malnutrition risk prevalence and clinical outcomes among acute hospital inpatients in Hong Kong

Abstract

Introduction. Studies have suggested that 20% to 50% of inpatients are malnourished. This study aimed to investigate the prevalence of malnutrition risk in inpatients at an acute hospital and to evaluate the association between nutritional risk and clinical outcomes. Methods. Records of 40,105 adult patients admitted to our hospital between January and December 2016 were retrieved. We recorded patient Malnutrition Screening Tool (MST) scores (range, 0–5) and outcomes after discharge from hospital such as length of hospital stay (LOS), 28-day emergency readmission rate, and death. The malnutrition risk was categorised into three levels according to MST score: low risk (0-1), medium risk (2), and high risk (≥3). We made comparisons among the three groups, and between the low-risk group and the mediumand high-risk (at-risk) group. Results. The prevalence of malnutrition risk was 9.2%. Malnutrition risk was 12.0% among those aged ≥65 years and 6.1% among those aged 18 to 65 years. The low-, mediumand high-risk groups differed significantly in terms of the mean patient age (64.2 vs. 70.8 vs. 73.7 years, p<0.01) and the mean LOS (4.2 vs. 6.4 vs. 7.4 days, p<0.001). The emergency readmission rate within 28 days was higher in at-risk patients than in low-risk patients (25.1% vs. 14.6%, odds ratio=2.0, p<0.001), as was the mortality rate (8.5% vs. 2.3%, odds ratio=3.9, p<0.001). Conclusion. Malnutrition is a common problem among hospitalised patients. The use of a validated malnutrition screening tool to lower the malnutrition risk is necessary. A multicentre cross-sectional study on the effect of malnutrition on clinical outcomes is needed for developing service-quality enhancement measures. 1 Dietetics Department, North District Hospital, New Territories, Hong Kong 2 Department of Surgery, North District Hospital, New Territories, Hong Kong 3 Central Nursing Department, North District Hospital, New Territories, Hong Kong Correspondence to: Dr Terry HY Ting, 1/F, Dietetics Department, North District Hospital, New Territories, Hong Kong. Email: tinghoyan@gmail.com intake owing to neurological disorders (including dysphagia) that decrease the ability to self-feed, sideeffects of drugs or treatments, or deterioration in taste and smell leading to a poor appetite.2 Malnutrition is more likely to develop in older adults with comorbid chronic conditions, impaired adaptation to inflammatory-catabolic states, or a heightened risk of acute diseases.3 By 2050, the number of older INTRODUCTION Malnutrition is defined as a state of nutrition in which an excess or deficiency of energy, macroand micro-nutrients causes adverse effects on clinical, functional, and economic outcomes.1 Malnutrition is common in health care settings, particularly in an acute care hospitals, when patients reduce their food