Inpatient and post-discharge course of the malnourished patient

A retrospective review of the medical records of 114 malnourished and 106 non-malnourished male veterans assessed the inpatient and 1 year post-discharge dietetic care given for the treatment of malnutrition. The malnourished sample consisted of subjects discharged with a protein-energy or protein malnutrition comorbidity. Subjects in the diagnosis-matched and age-matched control sample were discharged without a malnutrition comorbidity during the same period. Data collected from progress notes included diagnoses, inpatient dietetic feedings and services provided, discharge dietetic care, intervening clinic visits, and rehospitalizations. On initial admission, 79% of the diagnoses for the malnourished group fell into five diagnosis categories: neoplasms; respiratory system diseases; digestive system diseases; endocrine, nutritional, and metabolic diseases; and mental disorders (including alcohol-related disorders). Malnourished subjects received more specialized feedings and dietetic services than did the controls on initial admission. However, the discharge and post-discharge care received by surviving members of both groups was similar. Fewer than half the members of either group received post-discharge care. Fifty-four malnourished and 54 control patients were hospitalized more than once. The findings indicate that levels of inpatient and outpatient dietetic care need to be coordinated to alleviate malnutrition.