Malnutrition prevalence at hospital admission and discharge based on the two-step Global Leadership Initiative on Malnutrition: A prospective observational study in Malawian adult patients.

Objective: To assess the prevalence of malnutrition at hospital admission and discharge and examine factors associated with malnutrition at discharge among adult patients.

Study design: A prospective observational study was conducted at two public referral hospitals in Malawi, targeting adult patients aged 18-65 years (n = 418). Within 24-48 h of hospital admission, patients were screened for malnutrition risk using the Malnutrition Screening Tool and diagnosed with malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Patients (n = 229) with a length of stay (LOS) of ≥7 days were rescreened and reassessed at discharge.

Results: According to the GLIM criteria, at admission, 74.3% (n = 150) of the patients were diagnosed with malnutrition, of which 71.3% (n = 107) were moderately malnourished and 28.7% (n = 43) were severely malnourished. At discharge (≥7-day LOS), 81.5% (n = 101) were malnourished, with 35.6% (n = 36) and 64.4% (n = 65) being moderately and severely malnourished, respectively. Among patients who were severely malnourished at discharge (≥7-day LOS), 63.1% (n = 41) and 61.5% (n = 40) exhibited three of the GLIM phenotypic and two of the etiologic characteristics, respectively. Malnutrition at discharge (≥7-day LOS) was associated with a longer LOS (adjusted odds ratio [AOR], 1.206; 95% CI, 1.062-1.370; P = 0.004) and a history of previous hospital admission within the past 6 months (AOR, 4.146; 95% CI, 1.192-14.418; P = 0.025).

Conclusion: Malnutrition at admission and discharge is a serious concern in Malawi, necessitating tailored nutrition/dietetic interventions in the hospital, at discharge, and after discharge.