title: Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer.
abstract: BACKGROUND
  Undernutrition is a common complication of disease and a major determinant of hospital stay outcome. Dutch hospitals are required to screen for undernutrition on the first day of admission.
  
  
  OBJECTIVE
  We sought to determine the prevalence of the screening score "undernourished" with the use of the Short Nutritional Assessment Questionnaire (SNAQ) or Malnutrition Universal Screening Tool (MUST) and its relation to length of hospital stay (LOS) in the general hospital population and per medical specialty.
  
  
  METHODS
  We conducted an observational cross-sectional study at 2 university, 3 teaching, and 8 general hospitals. All adult inpatients aged ≥18 y with an LOS of at least 1 d were included. Between 2007 and 2014, the SNAQ/MUST score, admitting medical specialty, LOS, age, and sex of each patient were extracted from the digital hospital chart system. Linear regression analysis with ln(LOS) as an outcome measure and SNAQ ≥3 points/MUST ≥2 points, sex, and age as determinant variables was used to test the relation between SNAQ/MUST score and LOS.
  
  
  RESULTS
  In total, 564,063 patients were included (48% males and 52% females aged 62 ± 18 y). Of those, 74% (419,086) were screened with SNAQ and 26% (144,977) with MUST, and 13.7% (SNAQ) and 14.9% (MUST) of the patients were defined as being undernourished. Medical specialties with the highest percentage of the screening score of undernourished were geriatrics (38%), oncology (33%), gastroenterology (27%), and internal medicine (27%). Patients who had an undernourished screening score had a higher LOS than did patients who did not (median 6.8 compared with 4.0 d; P < 0.001). Regression analysis showed that a positive SNAQ/MUST score was significantly associated with LOS [SNAQ: +1.43 d (95% CI: 1.42, 1.44 d), P < 0.001; MUST: +1.47 d (95% CI: 1.45, 1.49 d), P < 0.001].
  
  
  CONCLUSIONS
  This study provides benchmark data on the prevalence of undernutrition, including more than half a million patients. One out of 7 patients was scored as undernourished. For geriatrics, oncology, gastroenterology, and internal medicine, this ratio was even greater (1 out of 3–4). Hospital stay was 1.4 d longer among undernourished patients than among those who were well nourished.
authors.forename: Hinke
authors.initials: H
authors.lastname: Kruizenga
authors.forename: Suzanne
authors.initials: S
authors.lastname: van Keeken
authors.forename: Peter
authors.initials: P
authors.lastname: Weijs
authors.forename: Luc
authors.initials: L
authors.lastname: Bastiaanse
authors.forename: Sandra
authors.initials: S
authors.lastname: Beijer
authors.forename: Getty
authors.initials: G
authors.lastname: Huisman-de Waal
authors.forename: Harriët
authors.initials: H
authors.lastname: Jager-Wittenaar
authors.forename: Cora
authors.initials: C
authors.lastname: Jonkers-Schuitema
authors.forename: Mariël
authors.initials: M
authors.lastname: Klos
authors.forename: Wineke
authors.initials: W
authors.lastname: Remijnse-Meester
authors.forename: Ben
authors.initials: B
authors.lastname: Witteman
authors.forename: Abel
authors.initials: A
authors.lastname: Thijs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires