Challenges of nutritional support administration and clinical outcomes in malnourished patients during...

Malnutrition is highly prevalent among hospitalized patients, and adequate nutrient intake plays a crucial role in their recovery. However, disruptions in diet, suspension of nutritional support, and delayed initiation of nutritional therapy can significantly undermine the effectiveness of nutritional treatment. This study aims to assess the administration of nutritional support and its clinical impact on malnourished patients admitted to a public hospital in Brazil.

This was a prospective observational study utilizing secondary data of patients hospitalized and receiving nutritional support between December 14, 2021, and May 14, 2023. Association analyses were performed. The exposure variables included the interval between hospitalization and the initiation of nutritional support and the number of diet interruptions. The primary outcome of this study was the mortality rate, and secondary outcomes included ICU admission, length of hospital stay, length of hospital stay with nutritional support, and presence of pressure injuries.

A total of 218 malnourished patients were included in the study. 82.1% of patients started nutritional support for more than 48 hours. 69.3% of patients had their diet interrupted at some point during hospitalization. Late initiation of nutritional support was associated with a longer length of stay in malnourished patients (P = 0.007).

Approximately two-thirds of the patients experienced at least one interruption in their diet infusion. Delayed initiation of nutritional support and diet interruptions, even when expected, have a negative impact on patients' clinical outcomes. Implementing standardized protocols is essential to address delays in nutritional support and minimize diet interruptions.