Malnutrition Diagnoses in Hospitalized Patients

Abstract

Malnutrition is common among hospitalized patients in the United States, and its coded prevalence is increasing. Malnutrition is known to be associated with increased morbidity, mortality and healthcare costs. Although national data indicate that the number of malnutrition diagnoses among hospital discharges has been steadily rising, an in-depth examination of the demographic and clinical characteristics of these patients has not been conducted. We examined data from the 2010 Healthcare Cost and Utilization Project (HCUP), the most recent nationally-representative data describing U.S. hospital discharges. Using ICD-9 codes, we constructed a composite variable indicating a diagnosis of malnutrition. Based on our definition, 3.2% of all U.S. hospital discharges in 2010 had this diagnosis. Relative to patients without a malnutrition diagnosis, those with the diagnosis were older, had longer lengths of stay and incurred higher costs. These patients were more likely to have 27 of 29 comorbidities assessed in HCUP. Finally, discharge to home care was twice as common among malnourished patients, and a discharge of death was more than 5 times as common among patients with a malnutrition diagnosis. Taken together, these nationally representative, cross-sectional data indicate that hospitalized patients discharged with a diagnosis of malnutrition are older and sicker and their inpatient care is more expensive than their counterparts without this diagnosis.

Risk factors associated with malnutrition in hospitalized patients

“…The study frequency of malnutrition was very similar to that found by other Brazilian and foreign studies 16,19,20 , corroborating the statement that along the last four decades, the prevalence of malnutrition has remained high 21 , increasing the length of hospital stay and risk of death 22 .…”

Malnutrition Diagnosis during Adult Inpatient Hospitalizations: Analysis of a Multi-Institutional Collaborative Database of Academic Medical Centers

“…[10][11][12] This topic is relevant because a lack of malnutrition diagnosis can have an adverse effect on patient care because malnutrition-based intervention is dependent on screening, assessment, and then diagnosis of malnourished patients. Indeed, recent quality improvement efforts have focused on improving malnutrition care.…”

“…12 The purpose of this study was to provide a contemporary evaluation of malnutrition diagnosis, with the hypothesis that the rate of reported malnutrition diagnosis has increased but remains underreported compared with malnutrition assessments. In addition, we sought to evaluate whether institutional factors were associated with increased malnutrition diagnosis.…”

Differentiating Malnutrition Screening and Assessment: A Nutrition Care Process Perspective

“…11 Therefore, many patients are either well-nourished on admission to the hospital and malnutrition develops during their stay, 12 are malnourished when they are admitted and are overlooked, or both. It is well-documented that malnourished patients have worse outcomes compared to well-nourished patients, including increased length of hospital stay, number of readmissions, decreased function and quality of life, increased mortality, and higher health care costs.…”