Ten-year all-cause mortality in hospitalized non-surgical patients based on nutritional status screening

Objective: Malnutrition is common in patients admitted to hospital due to acute illness and contributes to negative patient outcomes. In Slovakia there is a lack of relevant data on malnutrition in hospitalized patients, particularly based on chronic co-morbidity and survival. The aim of the present study was to explore the prevalence of malnutrition in hospitalized chronic patients, its relationship to co-morbidity and its impact on 10-year survival. Design: Retrospective cohort study. Setting: Nutritional status was estimated by Subjective Global Assessment (SGA), BMI and serum albumin level. Survival was assessed from the National Insurance Registry over a 10-year period. The association between nutritional status measured by SGA and 10-year survival controlling for age, gender, BMI and serum albumin was analysed using Cox regression. Subjects: Data were taken from the medical records of 202 consecutively admitted chronic patients. Results: Median age was 63.5 years; 55.4 % were males; median BMI was 25.9 kg/m(2); median serum albumin level was 39.0 g/l. Based on SGA evaluation, 38.1 % did not have sufficient nutritional status (SGA classification B and C). Malnutrition was more common in patients who were older (P=0.023), with lower BMI (P<0.001), who had gastrointestinal (P=0.049) and oncologic co-morbidity (P=0.021) and lower albumin level (P=0.049). In-hospital mortality was 3 %, but during the following 10 years 52 % died. Cox regression analysis controlling for age, gender, BMI and serum albumin showed that SGA was an independent predictor of death (hazard ratio=1.55; 95 % CI 1.04, 2.32; P=0.031). Conclusions: SGA is a simple screening tool that can be routinely used in hospitalized Slovak medical patients to predict the risk of death. Improving patient nutrition could thus reduce mortality.