title: The German hospital malnutrition study.
abstract: OBJECTIVE
  Malnutrition is frequently observed in chronic and severe diseases and associated with impaired outcome. In Germany general data on prevalence and impact of hospital malnutrition are missing.
  
  
  METHODS
  Nutritional state was assessed by subjective global assessment (SGA) and by anthropometric measurements in 1,886 consecutively admitted patients in 13 hospitals (n=1,073, university hospitals; n=813, community or teaching hospitals). Risk factors for malnutrition and the impact of nutritional status on length of hospital stay were analyzed.
  
  
  RESULTS
  Malnutrition was diagnosed in 27.4% of patients according to SGA. A low arm muscle area and arm fat area were observed in 11.3% and 17.1%, respectively. Forty-three % of patients 70 years old were malnourished compared to only 7.8% of patients <30 years. The highest prevalence of malnutrition was observed in geriatric (56.2%), oncology (37.6%), and gastroenterology (32.6%) departments. Multivariate analysis revealed three independent risk factors: higher age, polypharmacy, and malignant disease (all P<0.01). Malnutrition was associated with an 43% increase of hospital stay (P<0.001).
  
  
  CONCLUSIONS
  In German hospitals every fourth patient is malnourished. Malnutrition is associated with increased length of hospital stay. Higher age, malignant disease and major comorbidity were found to be the main contributors to malnutrition. Adequate nutritional support should be initiated in order to optimize the clinical outcome of these patients.
authors.affiliation: Medizinische Klinik-Gastroenterologie, Hepatologie und Endokrinologie, Charité-Universitätsmedizin Berlin, D 10098 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: Kristina
authors.initials: K
authors.lastname: Norman
authors.forename: Sylvia
authors.initials: S
authors.lastname: Gastell
authors.forename: Heinrich Josef
authors.initials: HJ
authors.lastname: Lübke
authors.forename: Stephan C
authors.initials: SC
authors.lastname: Bischoff
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bolder
authors.forename: Thomas
authors.initials: T
authors.lastname: Frieling
authors.forename: Helge
authors.initials: H
authors.lastname: Güldenzoph
authors.forename: Kristian
authors.initials: K
authors.lastname: Hahn
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Jauch
authors.forename: Karin
authors.initials: K
authors.lastname: Schindler
authors.forename: Jürgen
authors.initials: J
authors.lastname: Stein
authors.forename: Dorothee
authors.initials: D
authors.lastname: Volkert
authors.forename: Arved
authors.initials: A
authors.lastname: Weimann
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Werner
authors.forename: Christiane
authors.initials: C
authors.lastname: Wolf
authors.forename: Gudrun
authors.initials: G
authors.lastname: Zürcher
authors.forename: Peter
authors.initials: P
authors.lastname: Bauer
authors.forename: Herbert
authors.initials: H
authors.lastname: Lochs
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015992:Body Mass Index; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index