The German hospital malnutrition study.
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.
Pirlich
Matthias
M
Medizinische Klinik-Gastroenterologie, Hepatologie und Endokrinologie, Charité-Universitätsmedizin Berlin, D 10098 Berlin, Germany. matthias.pirlich@charite.de
Schütz
Tatjana
T
Norman
Kristina
K
Gastell
Sylvia
S
Lübke
Heinrich Josef
HJ
Bischoff
Stephan C
SC
Bolder
Ulrich
U
Frieling
Thomas
T
Güldenzoph
Helge
H
Hahn
Kristian
K
Jauch
Karl-Walter
KW
Schindler
Karin
K
Stein
Jürgen
J
Volkert
Dorothee
D
Weimann
Arved
A
Werner
Hansjörg
H
Wolf
Christiane
C
Zürcher
Gudrun
G
Bauer
Peter
P
Lochs
Herbert
H
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