title: Ten-year all-cause mortality in hospitalized non-surgical patients based on nutritional status screening.
abstract: OBJECTIVE
  Malnutrition is common in patients admitted to hospital due to acute illness and contributes to negative patient outcomes. In Slovakia there is a lack of relevant data on malnutrition in hospitalized patients, particularly based on chronic co-morbidity and survival. The aim of the present study was to explore the prevalence of malnutrition in hospitalized chronic patients, its relationship to co-morbidity and its impact on 10-year survival.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Nutritional status was estimated by Subjective Global Assessment (SGA), BMI and serum albumin level. Survival was assessed from the National Insurance Registry over a 10-year period. The association between nutritional status measured by SGA and 10-year survival controlling for age, gender, BMI and serum albumin was analysed using Cox regression.
  
  
  METHODS
  Data were taken from the medical records of 202 consecutively admitted chronic patients. Results Median age was 63·5 years; 55·4 % were males; median BMI was 25·9 kg/m2; median serum albumin level was 39·0 g/l. Based on SGA evaluation, 38·1 % did not have sufficient nutritional status (SGA classification B and C). Malnutrition was more common in patients who were older (P=0·023), with lower BMI (P<0·001), who had gastrointestinal (P=0·049) and oncologic co-morbidity (P=0·021) and lower albumin level (P=0·049). In-hospital mortality was 3 %, but during the following 10 years 52 % died. Cox regression analysis controlling for age, gender, BMI and serum albumin showed that SGA was an independent predictor of death (hazard ratio=1·55; 95 % CI 1·04, 2·32; P=0·031).
  
  
  CONCLUSIONS
  SGA is a simple screening tool that can be routinely used in hospitalized Slovak medical patients to predict the risk of death. Improving patient nutrition could thus reduce mortality.
authors: 1Department of Internal Medicine,Internal Clinic,Teaching Hospital Nitra,Spitalska 6,949 01 Nitra,Slovak Republic.
authors: Viera
authors: V
authors: Kissova
authors: 2Institute of Public Health and Graduate School Kosice,Institute for Society and Health,University PJ Safarik,Kosice,Slovak Republic.
authors: Jaroslav
authors: J
authors: Rosenberger
authors: 1Department of Internal Medicine,Internal Clinic,Teaching Hospital Nitra,Spitalska 6,949 01 Nitra,Slovak Republic.
authors: Maria
authors: M
authors: Goboova
authors: 3Medical Faculty,Comenius University,Bratislava,Slovak Republic.
authors: Adrian
authors: A
authors: Kiss
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002423:Cause of Death; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000401:mortality*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012709:Serum Albumin; D018154:Slovakia / Q000453:epidemiology
chemical_list: D012709:Serum Albumin
keywords: All-cause mortality; Co-morbidity; Nutritional status; Subjective Global Assessment (SGA); Survival
references: Clin Nutr. 2006 Aug;25(4):563-72
references: 16698132
references: Tohoku J Exp Med. 2010 May;221(1):29-34
references: 20448438
references: J Ren Nutr. 2013 Mar;23(2):141-7
references: 22677629
references: Acta Med Iran. 2012;50(3):197-202
references: 22418989
references: Clin Nutr. 2010 Aug;29(4):469-76
references: 20097458
references: J Chronic Dis. 1987;40(5):373-83
references: 3558716
references: Oncology. 2011;81(5-6):395-402
references: 22269999
references: Am J Clin Nutr. 1988 Mar;47(3):553
references: 3348165
references: J Am Soc Nephrol. 2010 Feb;21(2):223-30
references: 20075063
references: J Am Med Dir Assoc. 2013 Jan;14(1):53-7
references: 23141123
references: J Nutr Health Aging. 2012 Jan;16(1):100-6
references: 22238008
references: J Am Diet Assoc. 1995 Sep;95(9):984-92
references: 7657913
references: Int J Obes (Lond). 2010 Jun;34(6):1044-50
references: 20212495
references: Medicina (B Aires). 2010;70(2):120-6
references: 20447893
references: BMJ. 1994 Apr 9;308(6934):945-8
references: 8173401
references: Clin Nutr. 2013 Oct;32(5):737-45
references: 23260602
references: Arch Gerontol Geriatr. 2010 Sep-Oct;51(2):227-30
references: 19939476
references: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007 Dec;151(2):273-6
references: 18345263
references: Clin Nutr. 2011 Feb;30(1):49-53
references: 20708310
references: Am J Cardiol. 2011 Oct 15;108(8):1166-70
references: 21798500
references: JPEN J Parenter Enteral Nutr. 1987 Jan-Feb;11(1):8-13
references: 3820522
references: J Intern Med. 1998 Nov;244(5):387-95
references: 9845854
references: Eur J Intern Med. 2008 Dec;19(8):587-91
references: 19046723
references: Nephrol Dial Transplant. 2002 Jun;17(6):1085-92
references: 12032201
references: Clin Nutr. 2010 Oct;29(5):552-9
references: 20434820
references: J Orthop Surg (Hong Kong). 2010 Dec;18(3):265-70
references: 21187532
references: Nutr Hosp. 2008 Jan-Feb;23(1):68-74
references: 18372949
references: Eur J Clin Nutr. 2012 Nov;66(11):1224-8
references: 22990853