title: Clinical and financial implications of disease-related malnutrition in a department of Internal Medicine: prospective cohort study.
abstract: BACKGROUND
  Disease-related malnutrition is a challenge for Spanish hospitals. Our objective was to assess the feasibility and importance of establishing a nutritional screening strategy in our community.
  
  
  METHODS
  A prospective cohort study was conducted in a department of internal medicine for 3 months. The nutritional screening was conducted at admission and was repeated weekly using the Malnutrition Universal Screening Tool. We analysed the clinical data, mean stay and expenses.
  
  
  RESULTS
  The study included 330 patients (53.9% men), with a mean age of 77.8 years. The mean stay was 7 days, and the Charlson comorbidity index was 5.4. At admission, the Malnutrition Universal Screening Tool detected 26.9% of patients with a risk of malnutrition. Eighteen percent of the patients with a good nutritional state developed malnutrition during the hospitalisation. The patients with initially severe malnutrition had a longer mean stay. The patients whose nutritional state worsened during the hospitalisation had a significantly longer stay (2.5 days) compared with those whose state did not worsen. These cases of malnutrition caused a cost overrun of €767 per hospitalisation (35% greater), which entailed a malnutrition-related excess expenditure of €646,419.93 annually in the studied department. The appropriate coding resulted in an increase in mean weight from 2.11 to 2.81, which represented €82,568.52 and has not been previously quantified.
  
  
  CONCLUSIONS
  The high prevalence and clinical and financial implications of Disease-related malnutrition in patients hospitalised in internal medicine warrants establishing protocols for its early detection and treatment.
authors: Unidad de Nutrición Clínica y Dietética de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España. Electronic address: Mdballesteros@telefonica.net.
authors: M D
authors: MD
authors: Ballesteros-Pomar
authors: Unidad de Nutrición Clínica y Dietética de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors: A
authors: A
authors: Calleja-Fernández
authors: Medicina Interna, Complejo Asistencial Universitario de León, León, España.
authors: M
authors: M
authors: González-Valdés
authors: Unidad de Nutrición Clínica y Dietética de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors: B
authors: B
authors: Pintor-de la Maza
authors: Unidad de Nutrición Clínica y Dietética de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors: R
authors: R
authors: Villar Taibo
authors: Unidad de Nutrición Clínica y Dietética de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors: A
authors: A
authors: Vidal-Casariego
authors: Unidad de Nutrición Clínica y Dietética de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors: A
authors: A
authors: Urioste-Fondo
authors: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors: B
authors: B
authors: Torres-Torres
authors: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors: D
authors: D
authors: de Luis-Román
authors: Unidad de Nutrición Clínica y Dietética de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, León, España.
authors: I
authors: I
authors: Cano-Rodríguez
keywords: Costes sanitarios; Desnutrición relacionada con la enfermedad; Disease-related malnutrition; Healthcare costs; Nutritional support; Soporte nutricional