title: Does nutritional risk, as assessed by Nutritional Risk Index, increase during hospital stay? A multinational population-based study.
abstract: BACKGROUND
  Progressive nutritional depletion has been reported during hospital stay. This prospective study compared the proportion of nutritional risk at hospital admission in three European countries and further evaluated nutritional risk at late versus early phase of hospitalization in one hospital.
  
  
  METHODS
  Nutritional risk was determined in Geneva, Switzerland (n = 652), Berlin, Germany (n = 621) and Nice, France (n = 107) at hospital admission, and during hospital stay (0-100 d) in Nice (n = 527) by the Nutritional Risk Index (NRI) = (1.519 x serum albumin, g/l)+41.7 x (present weight/usual weight). NRI score of >100: no risk (NR); 97.5-100: mild risk; 83.5-97.5: moderate risk (MR); 83.5: severe risk (SR). Logistic regressions were used to determine the odds ratios (OR) between MR or SR and length of hospital stay (LOS) 16d compared to 1-15 d or nutritional assessment at 16-100 d compared to 1-15 d of hospitalization.
  
  
  RESULTS
  Patients, assessed at hospital admission, who were hospitalized >16d were more likely (P < 0.001) to be at MR (OR 2.0, CI 1.4-3.0) or SR (OR 3.3, CI 1.7-6.2) than patients hospitalized 1-15 d. Nice patients assessed at 16-100 d were more likely (P < 0.001) to be at MR (OR 5.4, CI 2.1-14.3) and SR (OR 14.7, CI 5.4-40.0) than patients assessed at 1-15 d of hospitalization.
  
  
  CONCLUSIONS
  The risk of MR or SR by NRI was greater in patients assessed during hospitalization than in patients assessed at hospital admission, which suggests that patients evaluated later during hospitalization are at greater risk than patients evaluated in the early phase of hospitalization. Ongoing assessment during hospitalization seems important to identify patients who are at increased risk for complications.
authors.affiliation: Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Ursula G
authors.initials: UG
authors.lastname: Kyle
authors.forename: Stephane M
authors.initials: SM
authors.lastname: Schneider
authors.forename: Matthias
authors.initials: M
authors.lastname: Pirlich
authors.forename: Herbert
authors.initials: H
authors.lastname: Lochs
authors.forename: Xavier
authors.initials: X
authors.lastname: Hebuterne
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
mesh_terms: D000704:Analysis of Variance; D001835:Body Weight / Q000502:physiology*; D016001:Confidence Intervals; D005260:Female; D005602:France; D005858:Germany; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D012720:Severity of Illness Index; D013557:Switzerland
chemical_list: D012709:Serum Albumin