1. Contributing factors of prolonged hospitalization in malnourished patients
PAPER ID 23480
Olga Sjomina1,2, Lilian Tzivian2, Alina Graubergere2, Aleksandra Jeniceka2, Ilva Daugule2, Zane Dzerve1,3, Igors Gubarevs4, Olesja Basina1,3, Mārcis Leja1,2 , Aleksejs Derovs 1,3
1Riga East University Hospital, Riga, Latvia; 2University of Latvia, Faculty of Medicine, Riga, Latvia; 3Riga Stradins University, Riga, Latvia; 4St. Barbara-Klinik, Hamm-Heessen, Germany
Overall, 149 patients participated , of them, 69 (46.3%) were men. Mean age of patients was (SD 17.6 years), median MUST showed that 33.6% of study sample is of high malnutrition risk. According to NRS results, 54 (36.2%) were high-risk patients, of them 57.1% were GD patients.
Malnourished hospitalized patients have higher mortality rate, higher prevalence of infective and non-infective complications, as well as a longer hospitalization length in comparison to those without malnutrition. ESPEN recommends two comprehensive tools for malnutrition screening – MUST or NRS The NRS-2002 tool is currently considered to be the most effective and sensitive malnutrition screening instrument, however, it is longer, and requires more complex calculations than MUST, which makes it inferior in conditions of time deficit.
Comparison of MUST and NRS reliability:
Length of hospitalization (days)
To compare the reliability of two comprehensive malnutrition screening tools (MUST and NRS-2002), as well as to evaluate factors which affect hospitalization length.
Low risk
Moderate risk
High risk
Design
Cross-sectional study,
Department of Gastroenterology (GD) - 49
Department of Endocrinology (ED) - 57
Department of General Surgery (SD) - 43
Protocol
Screening with MUST and NRS-2002
Questionnaire including epidemiologic, clinical and treatment data
Data processing
149 of 157 investigated patients
IBM SPSS 25.0
Direct acyclic graph for multidimensial analysis
Length of hospitalization (days)
Low risk
High risk
Difference is statistically significant (p < 0.001)
The reliability of both tests for a length of hospitalization is similarly high (Cronbach’s alpha = 0.92)
Length of hospitalization
Contributing factors:
Significance OR
95% CI OR
MUST
NRS
Tool
0.01
0.43
6.79
1.92
Age
0.02
1.05
1.04
Gender
0.07
0.16
3.57
2.53
Weight loss
0.56
<0.01
1.87
14.37
Profile
0.42
0.08
1.09
1.24
Low albumin level
0.06
5.71
10.82
Difference between GD and SD (p = 0.009), as well as GD and ED (p < 0.001)
More than a third of all hospitalized patients have had a high malnutrition risk according to both MUST and NRS screening tools.
Both screening tools used in the study showed a high reliability to predict increase of hospitalization length and are equally effective in detecting high-risk patients.