Nutritional risk among hospitalized patients: A repeated point-prevalence study

Adequate nutrition during hospitalization is essential for recovery and for reducing complications and mortality. This emphasizes the importance of nutritional treatment for patients at nutritional risk. The aim of the present study was to 1) assess the prevalence of nutritional risk, malnutrition, and coverage of energy and protein requirements over time and 2) to compare 30-day survival by nutritional risk and nutritional intake.

Three cross-sectional studies using a flash-mob approach were conducted at Herlev Hospital in 2019, 2023, and 2025. Inpatients ≥18 years and hospitalized ≥4 days were included. Intensive care-, palliative-, maternity-, and emergency wards were excluded. Data collected included nutritional risk, nutritional intake, disease-related malnutrition, and 30-day survival.

Of the 410 patients included, 65% were at nutritional risk in 2019 and 2023, compared with 75% in 2025, with an increasing trend observed from 2019 to 2025 (p = 0.040). Energy and protein requirements were met by 35% and 24% of patients in 2019, 70% and 51% in 2023, and 60% and 47% in 2025, respectively. From 2019 to 2025, an increasing trend was observed in the proportion of patients achieving ≥75% of energy (p = 0.028) and protein requirements (p = 0.013). The proportion classified as malnourished remained stable in 2023 and 2025 (60% vs. 59%). No difference in 30-day survival was observed between patients at nutritional risk who met ≥75% of estimated nutritional requirements and those who did not. After adjustment for age, sex, BMI, and length of hospital stay, nutritional risk was associated with lower 30-day survival (OR 0.46; 95% CI 0.23-0.94; p = 0.03).

The prevalence of nutritional risk remained consistently high across all audit years, while the proportion of patients meeting their estimated energy and protein requirements varied over time. Nutritional risk was associated with reduced 30-day survival, and the prevalence of malnutrition according to the GLIM criteria was also high. Taken together, these findings highlight the need to strengthen in-hospital nutritional interventions and ensure continuity of nutritional care after hospital discharge.