Prevalence of malnutrition and appropriateness of nutritional support in hospitalized patients: a GLIM-based study

To investigate the current status of nutritional risk, malnutrition, and nutritional therapy among hospitalized patients in Hunan Province, in order to provide evidence for optimizing clinical nutrition decision-making.

A multi-stage continuous sampling method was applied to survey hospitalized patients across 16 hospitals in Hunan Province from March 2022 to August 2023. Nutritional risk was assessed using the Nutritional Risk Screening 2002 (NRS2002), while malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Nutritional intervention status during hospitalization was recorded.

Among 3,189 participants, 36.4% (1,160/3,189) were identified as being at nutritional risk (NRS2002 ≥ 3), and of these, 68.2% (791/1,160) were diagnosed with malnutrition. Malnourished patients were older (65 ± 15 vs. 60 ± 13 years, p < 0.01), had lower BMI (20.2 ± 3.9 vs. 23.8 ± 3.5, p < 0.01), and incurred higher hospitalization costs (¥12,448.3 ± 12,064.3 vs. ¥10,070.3 ± 12,568.4, p = 0.038). High prevalence of nutritional risk and malnutrition was observed in infectious diseases, oncology, hematologic disorders, and respiratory diseases (prevalence>40%). Although 88.5% of malnourished patients received nutritional interventions, 10.9% received no support. Furthermore, 51.2% of patients without nutritional risk received unnecessary nutritional interventions.

This study underscores a dual challenge in clinical nutritional management: insufficient support for high-risk patients alongside the overuse of nutritional therapy in low-risk populations. There is an urgent need to implement standardized protocols for screening, assessment, diagnosis, intervention, and monitoring to improve clinical outcomes and promote the rational allocation of healthcare resources.

https://www.clinicaltrials.gov/study/NCT05694104? term=NCT05694104&rank=1, Identifier NCT05694104.