Prevalence of protein-energy malnutrition and associated health outcomes in adult patients across Australian rural hospital

摘要

Background: Malnutrition negatively impacts hospitalised patients and the healthcare system. The rural context requires specific examination as populations in rural areas have a higher elderly demographic than in urban areas. Aim: In three rural hospitals in New South Wales, 1) report point-prevalence of hospital malnutrition from 2012 to 2019; and 2) determine if there was an association between nutrition status and health-related outcomes. Methods: Point-prevalence of malnutrition was determined in adult patients across three Australian rural hospitals by three (2012, 2014, and 2019) cross-sectional studies. Nutrition status was assessed with the Subjective Global Assessment (SGA) tool. In-hospital falls, pressure ulcers, infections, fractures, length of stay, readmission, and mortality were observed from the medical record. Results: Malnutrition point prevalence was 39% in 2012 (n = 62), 48% in 2014 (n = 128), and 28% in 2019 (n = 96); where the prevalence in 2019 was significantly lower than in 2014 (P < 0.017). The 2019 (median age 70 years) sample was younger than the 2012 (median age 80 years) and 2014 (median age 78 years) samples (P < 0.05). Mortality and falls rate were higher in the severely malnourished participants (P = <0.05); and severe malnutrition may predict mortality (Adjusted OR: 3.47 (95%CI: 0.94, 12.78] P = 0.061). Nutrition status did not predict other health-related outcomes. Conclusions: In-line with historic evidence, the rate of malnutrition in rural hospitals was consistently high and may increase the risk of in-hospital mortality.