Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial.
OBJECTIVE
The objective of this study was to evaluate the impact of a nutritional intervention on hospital stay and mortality among hospitalized patients with malnutrition.


METHODS
Hospitalized patients with a diagnosis of malnutrition were enrolled and randomly allocated to either an intervention or control group. Participants in the intervention group received an individualized nutrition plan according to energy and protein (1.0-1.5 g/kg) intake requirements as well as dietary advice based on face-to-face interviews with patients and their caregivers or family members. Individuals in the control group received standard nutritional management according to the Hospital Nutrition Department. Nutritional status and disease severity were assessed using nutritional risk screening. Length of hospital stay was defined by the number of days of hospitalization from hospital admission to medical discharge. Reference to another service or death were criteria for study withdrawal. To evaluate mortality, individuals were followed up for 6 months after hospital discharge. Hospital stay and mortality were the intention-to-treat analysis.


RESULTS
A total of 55 patients with an average age of 57.1 ± 20.7 years were included into intervention (n = 28) and control (n = 27) groups, respectively. At basal condition, nutritional status, measured by nutritional risk screening score, was similar between the study groups (4.1 ± 0.8 vs 4.2 ± 1.2, p = 0.6). The average hospital stay was lower in the intervention group compared to the control group (6.4 ± 3.0 vs 8.4 ± 4.0 days, p = 0.03). Finally, the mortality rate at 6 months of follow-up was similar in both groups (hazard ratio [HR] = 0.85; 95% confidence interval [CI], 0.17-4.21).


CONCLUSIONS
Results of this study suggest that, in hospitalized patients with malnutrition, nutritional intervention and dietary advice decrease hospital stay but not mortality.
a Hospital San José, Escuela Nacional de Medicina del Tecnológico de Monterrey , Monterrey , Nuevo León , México.
Edgar A
EA
Cano-Torres
b Biomedical Research Unit of the Mexican Social Security Institute at Durango , Durango , Dgo ., México.
Luis E
LE
Simental-Mendía
a Hospital San José, Escuela Nacional de Medicina del Tecnológico de Monterrey , Monterrey , Nuevo León , México.
Luis A
LA
Morales-Garza
a Hospital San José, Escuela Nacional de Medicina del Tecnológico de Monterrey , Monterrey , Nuevo León , México.
José M
JM
Ramos-Delgado
a Hospital San José, Escuela Nacional de Medicina del Tecnológico de Monterrey , Monterrey , Nuevo León , México.
Mirthala M
MM
Reyes-Gonzalez
a Hospital San José, Escuela Nacional de Medicina del Tecnológico de Monterrey , Monterrey , Nuevo León , México.
Victor M
VM
Sánchez-Nava
c Hospital Metropolitano Dr. Bernardo Sepúlveda, Secretaria de Salud de Nuevo León , Monterrey , Nuevo León , México.
Abel de J
AJ
Barragán-Berlanga
a Hospital San José, Escuela Nacional de Medicina del Tecnológico de Monterrey , Monterrey , Nuevo León , México.
Ignacio
I
Rangel-Rodríguez
b Biomedical Research Unit of the Mexican Social Security Institute at Durango , Durango , Dgo ., México.
Fernando
F
Guerrero-Romero
D000328:Adult; D000368:Aged; D004032:Diet; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000178:diet therapy*; D008875:Middle Aged; D044623:Nutrition Therapy; D009752:Nutritional Status; D012307:Risk Factors
Nutritional intervention; hospital stay; hospitalized patients; malnutrition; mortality