Association of nutritional risk and adverse medical outcomes across different medical inpatient populations.

摘要: OBJECTIVE The aim of this study was to examine the prevalence nutritional risk and its association with multiple adverse clinical outcomes in a large cohort acutely ill medical inpatients from Swiss tertiary care hospital. METHODS We prospectively followed consecutive adult for 30 d. Multivariate regression models were used investigate initial Nutritional Risk Score (NRS 2002) mortality, impairment activities daily living (Barthel Index <95 points), hospital length stay, readmission rates, quality life (QoL; adapted EQ5 D); all parameters measured at 30 d. RESULTS Of 3186 patients (mean age 71 y, 44.7% women), 887 (27.8%) malnutrition an NRS ≥3 points. We found strong associations (odds ratio/hazard ratio [OR/HR], 95% confidence interval [CI]) between mortality (OR/HR, 7.82; CI, 6.04-10.12), impaired Barthel 2.56; 2.12-3.09), time discharge 0.48; 0.43-0.52), 1.46; 1.08-1.97), five dimensions QoL measures. Associations remained significant after adjustment sociodemographic characteristics, comorbidities, diagnoses. Results robust subgroup analysis evidence effect modification (P interaction < 0.05) based on main diagnosis groups. CONCLUSION Nutritional is associated increased resource use, outcomes, impairments functional ability QoL. Randomized trials are needed evaluate evidence-based preventive treatment strategies focusing factors improve these high-risk patients.