title: Prevalence of the notification of malnutrition in the departments of internal medicine and its prognostic implications.
abstract: OBJECTIVE
  Detection and notification of malnutrition are essential to adopt a support plan and take costs into account. The aim of this study was to describe how often discharge sheets from Internal Medicine (IM) units include malnutrition among diagnoses (notification frequency) using the International Classification of Diseases, 9th Revision Clinical Modification -ICD-9. Factors associated with this diagnosis and its prognostic implications are also assessed.
  
  
  METHODS
  The Minimum Basic Data Set from the Spanish hospitals (Ministry of Health and Consumer Affairs) was revised, and patients with diagnosis of malnutrition (ICD-9: 260-263.9) were identified.
  
  
  RESULTS
  1,567,659 patients were analysed (21,804-1.4%- with malnutrition). These patients were older (72.4 vs 70.8 years of age), had a greater degree of comorbidity (Charlson >2: 28% vs 23.5%), and resided in nursing homes more often (3.9% vs 1.9%) than the non-undernourished. The malnutrition associated diagnoses were: dementia, cancer, HIV infection and chronic renal failure. Mortality (19.5% vs 9.8%), hospital stay (18.1 vs 9.8 days), costs (5228.46 vs 3537.8 €) and relative weights applied to each Diagnosis Related Group (2.6 vs 1.1) were higher (p < 0.001 for all comparisons).
  
  
  CONCLUSIONS
  Notification of malnutrition in IM departments is low, below the prevalence described in inpatients. This diagnosis is associated with an increase in morbidity, mortality and costs.
authors.affiliation: Department of Internal Medicine, Hospital Clínico de San Carlos, Madrid, Spain. javier.marco@elmundo.es
authors.forename: Javier
authors.initials: J
authors.lastname: Marco
authors.forename: Raquel
authors.initials: R
authors.lastname: Barba
authors.forename: Antonio
authors.initials: A
authors.lastname: Zapatero
authors.forename: Pilar
authors.initials: P
authors.lastname: Matía
authors.forename: Susana
authors.initials: S
authors.lastname: Plaza
authors.forename: Juan Emilio
authors.initials: JE
authors.lastname: Losa
authors.forename: Jesús
authors.initials: J
authors.lastname: Canora
authors.forename: Gonzalo
authors.initials: G
authors.lastname: García de Casasola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D017721:Hospital Costs; D006801:Humans; D007388:Internal Medicine; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000191:economics / Q000401:mortality*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D015596:Nutrition Assessment; D015995:Prevalence; D013030:Spain