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Impact of a nutritional screening program on hospitalized patient outcomes ‒ A retrospective controlled real-world
David Benaiges Boix1, Carlos Pérez-López2, Laia Fontané1
1Department of Endocrinology and Nutrition. Consorci Sanitari Alt Penedès-Garraf (CSAPG).
Introduction:
evidence supporting universal malnutrition screening in hospitalized patients remains limited.
Objectives:
to assess the impact of a nutritional screening program on length of stay (LOS) (primary outcome), clinical and nutritional outcomes, and malnutrition detection.
Methods:
retrospective controlled study including adults (≥ 18 years) hospitalized for > 2 days for acute conditions in units of Consorci Sanitari de l'Alt Penedès-Garraf (CSAPG). Paired Screening and Control cohorts comprised patients hospitalized between September 2021 and September 2022 (post-implementation) and pre-implementation, respectively. The program included screening using the Malnutrition Screening Tool (MST), dietitian confirmation using Subjective Global Assessment (SGA), nutritional intervention, monitoring, and post-discharge follow-up. LOS, 30-day readmissions, mortality, and nutritional care were compared between cohorts.
Results:
we included 313 patient pairs from 369 recruited (mean [SD] age 73.9 [12.3] years). In the Screening cohort, 67 (21.4 %) had positive MST, 27 (8.6 %) were confirmed malnourished, and 41 (13.1 %) developed in-hospital malnutrition, yielding 68 (21.7 %) malnourished patients vs. 25 (8.0 %) in Controls. LOS, readmissions, or mortality lacked significant differences between cohorts. Within the Screening cohort, LOS was longer with positive (≥ 2) vs. negative MST (p = 0.007), in malnutrition at admission (p < 0.05), and highest with developing in-hospital malnutrition (p < 0.001). Dietitian consultations and supplementation were more frequent in the Screening cohort (p < 0.001 for both).
Conclusions:
a comprehensive nutritional screening program improved malnutrition detection and nutritional care but was not associated with differences in clinical outcomes. These findings highlight the organizational impact of universal screening programs and support optimizing detection strategies, including dynamic reassessment during hospitalization and adequate dietitian resources.