title: Nutritional risk screening and clinical outcome assessment among patients with community-acquired infection: A multicenter study in Beijing teaching hospitals.
abstract: OBJECTIVE
  The aim of this study was to implement nutritional risk screening in patients with community-acquired infection (CAI) and analyze its relationship with clinical outcomes.
  
  
  METHODS
  We consecutively assessed 595 patients with CAI from two teaching hospitals for eligibility during this study. Their nutritional risk was evaluated using Nutritional Risk Screening-2002. The hospital length of stay (LOS), rate of readmission, and nutritional support were recorded.
  
  
  RESULTS
  In all, 336 patients with CAI were recruited. Of these, 40.61% were at nutritional risk at admission. The prevalence of nutritional risk in those patients age ≥70 y was significantly higher than in younger patients (51.38% versus 37.29%; P = 0.017). There was significant increase in the prevalence of nutritional risk from admission to 2-wk post-admission in all patients (40.61% versus 48.93%; P = 0.036) and in elderly patients (51.38% versus 69.90%; P = 0.010). Of the at-risk patients, the LOS (19.6 ± 12.2 d versus 11.2 ± 5.3 d; P < 0.001) and the rate of readmission (8.8% versus 3.0%; P = 0.026) were significantly higher than those of the patients not at risk. Multivariate analysis showed nutritional support was a protective factor for longer LOS when adjusted for confounders (odds ratio, 0.51; 95% confidence interval, 0.36-0.68; P < 0.001). Only 55.9% of patients at risk received nutritional support and the average ratio of parenteral to enteral nutrition was 4.2:1.
  
  
  CONCLUSIONS
  Many patients with CAI were at nutritional risk and tended to worsen during hospitalization, which has been associated with increased LOS and rate of readmission. Nutritional support might be beneficial to the patients by shortening LOS. Inappropriate use of nutritional support was observed in patients with CAI.
authors.affiliation: Department of Anti-infection, The Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China.
authors.forename: Xiang-Yan
authors.initials: XY
authors.lastname: Li
authors.affiliation: Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. Electronic address: Yuk1997@sina.com.
authors.forename: Kang
authors.initials: K
authors.lastname: Yu
authors.affiliation: Department of Anti-infection, The Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Anti-infection, The Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China.
authors.forename: Yu-Fang
authors.initials: YF
authors.lastname: Wang
authors.affiliation: Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Rong-Rong
authors.initials: RR
authors.lastname: Li
authors.affiliation: Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000068476:Beijing / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000150:complications / Q000178:diet therapy* / Q000628:therapy; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000150:complications / Q000453:epidemiology; D018529:Nutritional Support; D010359:Patient Readmission; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Clinical outcome; Community-acquired infection; Nutritional risk; Nutritional risk screening; Nutritional support