Nutritional assessment associated with length of inpatients' hospital stay.

OBJECTIVE To evaluate the nutritional status of patients on hospital admission, identify the length of hospital stay and identify the parameters of nutritional assessment that are most closely related with the length of stay (LOS). METHODS A cross-sectional study of 278 hospitalized patients evaluated patients' nutritional status in the 48 hours after admission and their LOS after discharge. Anthropometric and biochemical parameters, related to nutrition status were analyzed, such as: weight, height, arm circumference (AC), waist circumference (WC), triceps skinfold thickness (TST), mild arm muscle circumference (MAMC), albumin (Alb) and hemoglobin (HB). Body mass index (BMI) was used to classify the nutritional status. All the nutritional factors except type of disease, gender and age were associated with LOS. The chi-square, Student-t, Mann-Whitney, Kruskal-Wallis and binary logistic multivariate tests were used in the statistical analyses. RESULTS The majority of patients was male (53%), elderly (56%) and had neoplasm (19.4%). Undernutrition was higher in the elderly (p < 0.05) and neoplasm patients (p < 0.05), overweight or obese patients were more likely to suffer from cardiovascular diseases (p = 0.001). Average LOS was 14.7 days (± 12.5), longer in neoplasm patients (p < 0.05) and in elderly ones (p < 0.05), and also was 3 times longer in males (p < 0.0001). Among the nutritional parameters, patients with AC under 25 cm had higher LOS (p < 0.05), but only in women could it be considered a marker, increasing LOS 2.8 times. BMI less than 20 kg/m(2) increased LOS 2.1 times, and biochemical data (Alb and HB) do not contribute. In the multivariate analyses, male gender and TST depletion were the significant factors, which together best explained the lengths of hospital stay. CONCLUSION LOS was associated with disease, gender, age and nutritional status. We can highlight two anthropometric analyses: first, AC can be used in women as a marker of longer LOS and second TST is the best overall predictor of longer hospital stay.

[1]  M. Burgos,et al.  Multidisciplinary consensus on the approach to hospital malnutrition in Spain. , 2011, Nutricion hospitalaria.

[2]  V. Leandro-Merhi,et al.  Nutrition status and risk factors associated with length of hospital stay for surgical patients. , 2011, JPEN. Journal of parenteral and enteral nutrition.

[3]  P. Garcia-Lorda,et al.  The burden of hospital malnutrition in Spain: methods and development of the PREDyCES® study. , 2010, Nutricion hospitalaria.

[4]  Ivan Cecconello,et al.  Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients. , 2010, Nutrition.

[5]  M. Camilo,et al.  A longitudinal study of hospital undernutrition in the elderly: Comparison of four validated methods , 2009, The journal of nutrition, health & aging.

[6]  María Dolores Ruiz López,et al.  Desnutrición hospitalaria: relación con la estancia media y la tasa de reingresos prematuros , 2009 .

[7]  P. Suter,et al.  How important is malnutrition? A prospective study in internal medicine , 2009, European Journal of Clinical Nutrition.

[8]  A. J. Pérez de la Cruz,et al.  [Hospital malnutrition: relation between the hospital length of stay and the rate of early readmissions]. , 2009, Medicina clinica.

[9]  A. V. van Bodegraven,et al.  Diagnosis and treatment of (disease-related) in-hospital malnutrition: the performance of medical and nursing staff. , 2008, Clinical nutrition.

[10]  S. Pértega,et al.  [Prevalence of malnutrition in medical and surgical wards of a university hospital]. , 2008, Nutricion hospitalaria.

[11]  V. Fuchs,et al.  Estado nutricio en pacientes internados en un hospital público de la ciudad de México , 2008 .

[12]  G. G. Salmeán,et al.  [Nutritional status in hospitalized patients in a public hospital in Mexico City]. , 2008, Nutricion hospitalaria.

[13]  Claude Pichard,et al.  Prognostic impact of disease-related malnutrition. , 2008, Clinical nutrition.

[14]  E. Isenring,et al.  Nutritional status and length of stay in patients admitted to an Acute Assessment Unit. , 2007, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[15]  M. Elia,et al.  Deprivation linked to malnutrition risk and mortality in hospital , 2006, British Journal of Nutrition.

[16]  Dorothee Volkert,et al.  The German hospital malnutrition study. , 2006, Clinical nutrition.

[17]  M. Elia,et al.  ‘Malnutrition Universal Screening Tool’ predicts mortality and length of hospital stay in acutely ill elderly , 2006, British Journal of Nutrition.

[18]  D. Waitzberg,et al.  The impact of malnutrition on morbidity, mortality and length of hospital stay in trauma patients. , 2005, Nutricion hospitalaria.

[19]  H. Adèr,et al.  Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients. , 2005, The American journal of clinical nutrition.

[20]  S. Gariballa,et al.  Age as a determinant of nutritional status: A cross sectional study , 2005, Nutrition journal.

[21]  C. Pichard,et al.  Hospital length of stay and nutritional status , 2005, Current opinion in clinical nutrition and metabolic care.

[22]  C. Pichard,et al.  Increased length of hospital stay in underweight and overweight patients at hospital admission: a controlled population study. , 2005, Clinical nutrition.

[23]  R. Burgos,et al.  Nutritional status among adult patients admitted to an university-affiliated hospital in Spain at the time of genoma. , 2004, Clinical nutrition.

[24]  Á. Asensio,et al.  Factores pronósticos de mortalidad relacionados con el estado nutricional en ancianos hospitalizados , 2004 .

[25]  Á. Asensio,et al.  [Prognostic factors for mortality related to nutritional status in the hospitalized elderly]. , 2004, Medicina clinica.

[26]  Matthias Pirlich,et al.  Prevalence of Malnutrition in Hospitalized Medical Patients: Impact of Underlying Disease , 2003, Digestive Diseases.

[27]  M. Correia,et al.  Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study. , 2003, Nutrition.

[28]  E. Hennessy,et al.  A comparison of mid upper arm circumference, body mass index and weight loss as indices of undernutrition in acutely hospitalized patients. , 2003, Clinical nutrition.

[29]  C. Pennington,et al.  Nutritional status of elective gastrointestinal surgery patients pre- and post-operatively. , 2002, Clinical nutrition.

[30]  W. Caiaffa,et al.  Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. , 2001, Nutrition.

[31]  J P McWhirter,et al.  Incidence and recognition of malnutrition in hospital , 1994, BMJ.

[32]  Lipschitz Da.  Screening for nutritional status in the elderly. , 1994 .

[33]  D. Lipschitz.  Screening for nutritional status in the elderly. , 1994, Primary care.

[34]  C. Long,et al.  Serum albumin. Differences in assay specificity. , 1989, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[35]  A. R. Frisancho,et al.  New norms of upper limb fat and muscle areas for assessment of nutritional status. , 1981, The American journal of clinical nutrition.