title: Social risk factors for hospital malnutrition.
abstract: OBJECTIVE
  Disease severity is considered an important risk factor for malnutrition in hospitalized patients. We investigated the effect of social factors and disease parameters on the development of malnutrition.
  
  
  METHODS
  Nutritional state was assessed by the Subjective Global Assessment in 794 consecutively admitted patients in two hospitals in Berlin (n = 493, university hospital; n = 301, district hospital). The influences of age, sex, social status, life habits, and disease parameters on nutritional state was analyzed with univariate and multivariate logistic regression methods.
  
  
  RESULTS
  Malnutrition was diagnosed in 22% of patients. Its prevalence was significantly higher in patients with malignant than with benign diseases (odds ratio [OR] = 1.568, P < 0.05) and in patients with multiple prescriptions (OR = 1.154, P < 0.001), but no difference was found between medical or surgical patients. The strongest risk factors for malnutrition in univariate analysis were age older than 60 y (OR = 2.861, P < 0.001), living alone (OR = 1.769, P = 0.002), and achieving a lower level of education (OR = 1.589, P < 0.05). Therefore, multivariate analysis was performed after stratification for age. Demonstrated independent additional risk factors were polypharmacy (OR = 2.367, P < 0.001) and malignant disease (OR = 4.114, P < 0.001) in young patients and polypharmacy (OR = 1.109, P < 0.002) and living alone (OR = 1.830, P = 0.008) in patients 60 y and older.
  
  
  CONCLUSIONS
  These data show that patients who are older, less educated, and live alone are at high risk of developing malnutrition. Thus special attention should be given to these risk groups when evaluating nutritional status and nutritional support.
authors.affiliation: Medizinische Klinik mit Schwerpunkt Gastroenterologie, Hepatologie und Endokrinologie, Charité-Universitätsmedizin, Berlin, Germany. matthias.pirlich@charite.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Pirlich
authors.forename: Tatjana
authors.initials: T
authors.lastname: Schütz
authors.forename: Martin
authors.initials: M
authors.lastname: Kemps
authors.forename: Niklas
authors.initials: N
authors.lastname: Luhman
authors.forename: Natalie
authors.initials: N
authors.lastname: Minko
authors.forename: Heinrich Josef
authors.initials: HJ
authors.lastname: Lübke
authors.forename: Karin
authors.initials: K
authors.lastname: Rossnagel
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Willich
authors.forename: Herbert
authors.initials: H
authors.lastname: Lochs
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D005858:Germany / Q000453:epidemiology; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008019:Life Style; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000502:physiology; D016017:Odds Ratio; D019338:Polypharmacy; D015995:Prevalence; D012044:Regression Analysis; D012111:Residence Characteristics; D012307:Risk Factors; D012923:Social Class