title: Self-rated health, nutritional intake and mortality in adult hospitalized patients.
abstract: BACKGROUND
  In the general population, poor self-rated health (SRH) is associated with malnutrition; however, these associations have not been studied in hospitalized patients. We aimed to evaluate SRH, indicators of nutrition, nutritional status and their association with in-hospital mortality.
  
  
  METHODS
  The study is based on data from the nutritionDay, a multinational, multicentre European-wide standardized 1-day cross-sectional survey of nutritional factors, food intake and in-hospital mortality in hospitalized patients. A data set of surveys on SRH in 2010 and 2011 was used in the analysis.
  
  
  RESULTS
  Complete sets of data were available for 28 106 patients (64 ± 18 years, 50% men, 7% terminally ill). In relation to body mass index, 7% were undernourished and 16% were obese. Fair/poor SRH was reported by 59% of patients and was associated with low food intake during the previous week or on survey day (P < 0·005). Thirty-day in-hospital mortality was 3%; in adjusted multivariate survival analysis, fair/poor SRH [hazard ratio (HR) 1·53, 95% confidence interval (CI) 1·14-2·05] and reduced food intake [nothing eaten (HR 2·13, 95% CI 1·46-3·11) or not allowed to eat on nutritionDay (HR 2·01, 95% CI 1·30-3·11)] predicted fatal outcome. At particularly high risk were patients who rated their health poor and had reduced food intake on the survey day or within the previous week with relative risks of 7·37 and 8·80, respectively.
  
  
  CONCLUSIONS
  We demonstrated high prevalence of poor SRH and insufficient food intake in hospitalized patients. This was associated, particularly in combination, with increased risk of in-hospital mortality.
authors.affiliation: Department of Cardiology, General Hospital Celje, Celje, Slovenia; Applied Cachexia Research, Charite Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
authors.forename: Jerneja
authors.initials: J
authors.lastname: Farkas
authors.forename: Sophie
authors.initials: S
authors.lastname: Frantal
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
authors.forename: Peter
authors.initials: P
authors.lastname: Bauer
authors.forename: Michael
authors.initials: M
authors.lastname: Hiesmayr
authors.forename: Karin
authors.initials: K
authors.lastname: Schindler
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004435:Eating / Q000502:physiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000401:mortality* / Q000503:physiopathology; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D057566:Self Report; D017678:Sex Distribution
keywords: Cross-sectional survey; mortality; nutritional intake; self-rated health