Malnutrition and sarcopenia worsen short- and long-term outcomes in internal medicine inpatients

Abstract

AbstractPurposeThis work aims to describe patients hospitalized in internal medicine wards in terms of nutrition and sarcopenia. It also seeks to evaluate short- and long-term mortality related to malnutrition and sarcopenia.MethodsThis cross-sectional study collected data on consecutive patients admitted to a single center’s internal medicine ward. Patients were recruited in May and October 2021. Malnutrition was determined by the Mini-Nutritional Assessment-Short Form (MNA-SF) and sarcopenia by the Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls questionnaire (SARC-F scale) and handgrip strength test. Patients who were hospitalized for >48 hours were excluded.ResultsThe sample included 619 patients with a mean ± SD age of 76.0 ± 14.8 years of which 50.6% were women. Patients were classified into three groups based on malnutrition: group 1 (MNA-SF 12–14 points) (no risk) included 158 patients, group 2 (MNA-SF 8–12 points) (high risk) included 233 patients, and group 3 (MNA-SF 0–7 points) (malnourished) included 228 patients. Malnourished patients had more dysphagia, significantly lower protein and albumin levels, and significantly higher inflammatory marker levels and pressure ulcers. In-hospital mortality was significantly higher in groups 2 and 3 (p < .00001). The worst outcome (mortality and readmissions or mortality) was more common among malnourished patients (p = .0001). Inflammation, comorbidity, and sarcopenia were most closely associated with negative outcomes.ConclusionMalnutrition upon admission is associated with worse short- and long-term outcomes in internal medicine inpatients. Sarcopenia, multimorbidity, and inflammation—measured by albumin, C-reactive protein, or their ratios—are key risk factors. Early identification of malnutrition and sarcopenia through active screening is important in caring for internal medicine patients.