Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National Study
BackgroundStudies are scarce in China that explore the association of nutritional status, measured using the Short-Form Mini Nutritional Assessment (MNA-SF) and biochemical data, on adverse clinical outcomes among older inpatients. In this study, we aimed to determine the prevalence of malnutrition...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-01-01
|
| Series: | Frontiers in Nutrition |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.815578/full |
| _version_ | 1818952557789184000 |
|---|---|
| author | Hongpeng Liu Jing Jiao Minglei Zhu Xianxiu Wen Jingfen Jin Hui Wang Dongmei Lv Shengxiu Zhao Xiang Sun Xinjuan Wu Tao Xu |
| author_facet | Hongpeng Liu Jing Jiao Minglei Zhu Xianxiu Wen Jingfen Jin Hui Wang Dongmei Lv Shengxiu Zhao Xiang Sun Xinjuan Wu Tao Xu |
| author_sort | Hongpeng Liu |
| collection | DOAJ |
| description | BackgroundStudies are scarce in China that explore the association of nutritional status, measured using the Short-Form Mini Nutritional Assessment (MNA-SF) and biochemical data, on adverse clinical outcomes among older inpatients. In this study, we aimed to determine the prevalence of malnutrition in tertiary hospitals of China and the associations between malnutrition and adverse clinical outcomes.MethodsThis prospective study involved 5,516 older inpatients (mean age 72.47 ± 5.77 years) hospitalized in tertiary hospitals between October 2018 and February 2019. The tertiary hospitals refer to the hospital with more than 500 beds and can provide complex medical care services. The MNA-SF was used to assess nutritional status. Multiple logistic regression and negative binomial regression were used to analyze the relationship between nutritional parameters and risk of hospital length of stay (LoS), mortality, and rehospitalization.ResultsWe found that 46.19% of hospitalized patients had malnutrition or malnutrition risk, according to the MNA-SF. Death occurred in 3.45% of patients. MNA-SF scores 0–7 (odds ratio [OR] 5.738, 95% confidence interval [CI] 3.473 to 9.48) were associated with a six-fold higher likelihood of death, and scores 8–11 (OR 3.283, 95% CI 2.126–5.069) with a three-fold higher likelihood of death, compared with MNA-SF scores 12–14 in the logistic regression model, after adjusting for potential confounders. A low MNA-SF score of 0–7 (regression coefficient 0.2807, 95% CI 0.0294–0.5320; P < 0.05) and a score of 8–11 (0.2574, 95% CI 0.0863–0.4285; P < 0.01) was associated with a significantly higher (28.07 and 25.74%, respectively) likelihood of increased LoS, compared with MNA-SF score 12–14. MNA-SF scores 0–7 (OR 1.393, 95% CI 1.052–1.843) and 8–11 (OR 1.356, 95% CI 1.124–1.636) were associated with a nearly 1.5-fold higher likelihood of 90-day readmission compared with MNA-SF scores 12–14 in the logistic regression model. Moreover, hemoglobin level, female sex, education level, former smoking, BMI 24–27.9 kg/m2, age 75 years and above, and current alcohol consumption were the main factors influencing clinical outcomes in this population.ConclusionsMalnutrition increases the risk of hospital LoS, mortality, and 90-day readmission. The use of nutritional assessment tools in all hospitalized patients in China is needed. The MNA-SF combined with hemoglobin level may be used to identify older inpatients with a high risk of adverse clinical outcomes. These findings may have important implications for the planning of hospital services. |
| first_indexed | 2024-12-20T09:52:17Z |
| format | Article |
| id | doaj.art-ccf0de26a65f4ff6a9149b19e8eb6aef |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-12-20T09:52:17Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-ccf0de26a65f4ff6a9149b19e8eb6aef2022-12-21T19:44:34ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-01-01910.3389/fnut.2022.815578815578Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National StudyHongpeng Liu0Jing Jiao1Minglei Zhu2Xianxiu Wen3Jingfen Jin4Hui Wang5Dongmei Lv6Shengxiu Zhao7Xiang Sun8Xinjuan Wu9Tao Xu10Department of Nursing, Chinese Academy of Medical Sciences—Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, ChinaDepartment of Nursing, Chinese Academy of Medical Sciences—Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, ChinaDepartment of Geriatrics, Chinese Academy of Medical Sciences—Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, ChinaDepartment of Nursing, Sichuan Provincial People's Hospital, Chengdu, ChinaDepartment of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Nursing, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Nursing, The Second Affiliated Hospital of Haerbin Medical University, Haerbin, ChinaDepartment of Nursing, Qinghai Provincial People's Hospital, Xining, ChinaDepartment of Nursing, Chinese Academy of Medical Sciences—Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, ChinaDepartment of Nursing, Chinese Academy of Medical Sciences—Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, ChinaDepartment of Epidemiology and Statistics, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences and School of Basic Medicine, Beijing, ChinaBackgroundStudies are scarce in China that explore the association of nutritional status, measured using the Short-Form Mini Nutritional Assessment (MNA-SF) and biochemical data, on adverse clinical outcomes among older inpatients. In this study, we aimed to determine the prevalence of malnutrition in tertiary hospitals of China and the associations between malnutrition and adverse clinical outcomes.MethodsThis prospective study involved 5,516 older inpatients (mean age 72.47 ± 5.77 years) hospitalized in tertiary hospitals between October 2018 and February 2019. The tertiary hospitals refer to the hospital with more than 500 beds and can provide complex medical care services. The MNA-SF was used to assess nutritional status. Multiple logistic regression and negative binomial regression were used to analyze the relationship between nutritional parameters and risk of hospital length of stay (LoS), mortality, and rehospitalization.ResultsWe found that 46.19% of hospitalized patients had malnutrition or malnutrition risk, according to the MNA-SF. Death occurred in 3.45% of patients. MNA-SF scores 0–7 (odds ratio [OR] 5.738, 95% confidence interval [CI] 3.473 to 9.48) were associated with a six-fold higher likelihood of death, and scores 8–11 (OR 3.283, 95% CI 2.126–5.069) with a three-fold higher likelihood of death, compared with MNA-SF scores 12–14 in the logistic regression model, after adjusting for potential confounders. A low MNA-SF score of 0–7 (regression coefficient 0.2807, 95% CI 0.0294–0.5320; P < 0.05) and a score of 8–11 (0.2574, 95% CI 0.0863–0.4285; P < 0.01) was associated with a significantly higher (28.07 and 25.74%, respectively) likelihood of increased LoS, compared with MNA-SF score 12–14. MNA-SF scores 0–7 (OR 1.393, 95% CI 1.052–1.843) and 8–11 (OR 1.356, 95% CI 1.124–1.636) were associated with a nearly 1.5-fold higher likelihood of 90-day readmission compared with MNA-SF scores 12–14 in the logistic regression model. Moreover, hemoglobin level, female sex, education level, former smoking, BMI 24–27.9 kg/m2, age 75 years and above, and current alcohol consumption were the main factors influencing clinical outcomes in this population.ConclusionsMalnutrition increases the risk of hospital LoS, mortality, and 90-day readmission. The use of nutritional assessment tools in all hospitalized patients in China is needed. The MNA-SF combined with hemoglobin level may be used to identify older inpatients with a high risk of adverse clinical outcomes. These findings may have important implications for the planning of hospital services.https://www.frontiersin.org/articles/10.3389/fnut.2022.815578/fullmalnutrition parametersmortalitylength of stayreadmissionolder inpatientsnutritional epidemiology |
| spellingShingle | Hongpeng Liu Jing Jiao Minglei Zhu Xianxiu Wen Jingfen Jin Hui Wang Dongmei Lv Shengxiu Zhao Xiang Sun Xinjuan Wu Tao Xu Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National Study Frontiers in Nutrition malnutrition parameters mortality length of stay readmission older inpatients nutritional epidemiology |
| title | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National Study |
| title_full | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National Study |
| title_fullStr | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National Study |
| title_full_unstemmed | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National Study |
| title_short | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National Study |
| title_sort | nutritional status according to the short form mini nutritional assessment mna sf and clinical characteristics as predictors of length of stay mortality and readmissions among older inpatients in china a national study |
| topic | malnutrition parameters mortality length of stay readmission older inpatients nutritional epidemiology |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.815578/full |
| work_keys_str_mv | AT hongpengliu nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT jingjiao nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT mingleizhu nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT xianxiuwen nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT jingfenjin nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT huiwang nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT dongmeilv nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT shengxiuzhao nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT xiangsun nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT xinjuanwu nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy AT taoxu nutritionalstatusaccordingtotheshortformmininutritionalassessmentmnasfandclinicalcharacteristicsaspredictorsoflengthofstaymortalityandreadmissionsamongolderinpatientsinchinaanationalstudy |