Prognostic indices of poor nutritional status and their impact on prolonged hospital stay in a Greek university hospital.
BACKGROUND
To ascertain the potential contributors to nutritional risk manifestation and to disclose the factors exerting a negative impact on hospital length of stay (LOS), by means of poor nutritional status, in a nonselected hospitalized population.


METHODS
NutritionDay project questionnaires were applied to 295 adult patients. Study parameters included anthropometric data, demographics, medical history, dietary-related factors, and self-perception of health status. Body Mass Index (BMI) and Malnutrition Universal Screening Tool (MUST) were calculated for each participant. MUST score was applied for malnutrition assessment, while hospital LOS constituted the outcome of interest.


RESULTS
Of the total cohort, 42.3% were at nutritional risk and 21.4% malnourished. Age, gender, BMI, MUST score, autonomy, health quality, appetite, quantity of food intake, weight loss, arm or calf perimeter (P < 0.001, for all), and dietary type (P < 0.01) affected nutritional status. Poor nutrition status (P = 0.000), deteriorated appetite (P = 0.000) or food intake (P = 0.025), limited autonomy (P = 0.013), artificial nutrition (P = 0.012), weight loss (P = 0.010), and arm circumference <21 cm (P = 0.007) were the most powerful predictors of hospital LOS >7 days.


CONCLUSIONS
Nutritional status and nutrition-related parameters such as weight loss, quantity of food intake, appetite, arm circumference, dietary type, and extent of dependence confer considerable prognostic value regarding hospital LOS in acute care setting.
Department of Anesthesiology, Faculty of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Georgia
G
Tsaousi
Department of Surgery, Faculty of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Stavros
0000-0001-7354-5456
S
Panidis
Department of Surgery, Faculty of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
George
G
Stavrou
Department of Surgery, Faculty of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
John
J
Tsouskas
Department of Surgery, Faculty of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Dimitrios
D
Panagiotou
Department of Surgery, Faculty of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Katerina
K
Kotzampassi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D015992:Body Mass Index; D004032:Diet; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012307:Risk Factors; D015431:Weight Loss