title: Is nutritional depletion by Nutritional Risk Index associated with increased length of hospital stay? A population-based study.
abstract: BACKGROUND
  Malnutrition is common at hospital admission and tends to worsen during hospitalization. This controlled population study aimed to determine if serum albumin or moderate and severe nutritional depletion by Nutritional Risk Index (NRI) at hospital admission are associated with increased length of hospital stay (LOS) (and increased hospital cost) in patients admitted to hospitals in 2 European countries.
  
  
  METHODS
  Serum albumin levels and recent weight loss were prospectively determined at hospital admission in Geneva (n = 652) and Berlin (n = 621). Patients were classified as no, mild, moderate or severe risk by NRI. Multiple logistic regressions were used to determine the association between albumin and nutritional risk category and LOS.
  
  
  RESULTS
  Patients (24%) were at moderate or severe nutritional risk by NRI. Nutritional risk by NRI, adjusted for age, was associated with LOS of 11 days (moderate: odds ratio [OR] 1.9, 95% confidence interval [CI] 1.4 to 2.7, p < .005; severe: OR 2.9, 95% CI 1.6 to 5.3, p < .005). Serum albumin was also significantly associated with increased LOS (p < .001).
  
  
  CONCLUSIONS
  The prevalence of nutritional depletion assessed by NRI and albumin was increased with longer LOS. Albumin alone underestimated nutritional risk. Severe nutritional depletion by NRI was significantly associated with LOS > or = 11 days in Geneva and Berlin patients. Nutrition screening should take place at hospital admission to determine nutritional risk and risk for longer LOS.
authors.affiliation: Department of Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Ursula G
authors.initials: UG
authors.lastname: Kyle
authors.forename: Matthias
authors.initials: M
authors.lastname: Pirlich
authors.forename: Tatjana
authors.initials: T
authors.lastname: Schuetz
authors.forename: Herbert
authors.initials: H
authors.lastname: Lochs
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D005260:Female; D005858:Germany / Q000453:epidemiology; D017721:Hospital Costs; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012709:Serum Albumin / Q000032:analysis*; D013557:Switzerland / Q000453:epidemiology
chemical_list: D012709:Serum Albumin