Evaluation of clinical outcomes after an intervention in malnourished hospitalized patients

Malnutrition is associated with higher mortality, lower functional capacity, and longer hospital stays. The goal of this study was to evaluate the effectiveness of a nutritional intervention in patients admitted to a hospital with disease-related malnutrition (DRM).

Pragmatic effectiveness study of patients recruited at three university hospitals with esophageal, gastric, pancreatic, colon, and rectal cancers, acute pancreatitis, or inflammatory bowel diseases (IBDs), with three groups: patients without DRM with no explicit nutritional intervention; patients with moderate to severe DRM on whom a nutritional intervention was performed; and patients with moderate to severe DRM who received standard care. DRM was diagnosed using the MUST and GLIM criteria. Depending on the outcome variable, survival, logistic regression, or generalized multilevel linear multivariable models were used.

1051 patients were included in the study. Multivariate multilevel analysis showed no difference in 30-day mortality or readmission at 90 days between the DRM groups and those without DRM. For death at 90 days, DRM patients without intervention had a higher risk but those with intervention did not. Length of hospital stay was greater in both of the DRM groups, but there were no differences in the rate of infectious complications. We found no differences in the change in the three nutritional parameters evaluated (weight, calf circumference, and hand-grip strength) between admission and discharge.

Nutritional intervention in hospitalized patients has been shown to be beneficial for post-discharge mortality; however, in order to achieve greater benefits, it should be maintained after discharge. Registered in ClinicalTrials.gov with ID NCT04188990.