Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer

Harriët Jager-Wittenaar, Hinke Kruizenga, Suzanne van Keeken, Peter Weijs, Luc Bastiaanse, Sandra Beijer, Getty Huisman-de Waal, Cora Jonkers-Schuitema, Mariël Klos, Wineke Remijnse-Meester, Ben Witteman, Abel Thijs

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Undernutrition is a common complication of disease and a major determinant of hospital stay outcome. Dutch hospitals are required to screen for undernutrition on the first day of admission. Objective: We sought to determine the prevalence of the screening score “undernourished” with the use of the Short Nutritional Assessment Questionnaire (SNAQ) or Malnutrition Universal Screening Tool (MUST) and its relation to length of hospital stay (LOS) in the general hospital population and per medical specialty. Design: We conducted an observational cross-sectional study at 2 university, 3 teaching, and 8 general hospitals. All adult inpatients aged ≥18 y with an LOS of at least 1 d were included. Between 2007 and 2014, the SNAQ/MUST score, admitting medical specialty, LOS, age, and sex of each patient were extracted from the digital hospital chart system. Linear regression analysis with ln(LOS) as an outcome measure and SNAQ ≥3 points/MUST ≥2 points, sex, and age as determinant variables was used to test the relation between SNAQ/MUST score and LOS. Results: In total, 564,063 patients were included (48% males and 52% females aged 62 ± 18 y). Of those, 74% (419,086) were screened with SNAQ and 26% (144,977) with MUST, and 13.7% (SNAQ) and 14.9% (MUST) of the patients were defined as being undernourished. Medical specialties with the highest percentage of the screening score of undernourished were geriatrics (38%), oncology (33%), gastroenterology (27%), and internal medicine (27%). Patients who had an undernourished screening score had a higher LOS than did patients who did not (median 6.8 compared with 4.0 d; P < 0.001). Regression analysis showed that a positive SNAQ/MUST score was significantly associated with LOS [SNAQ: +1.43 d (95% CI: 1.42, 1.44 d), P < 0.001; MUST: +1.47 d (95% CI: 1.45, 1.49 d), P < 0.001]. Conclusions: This study provides benchmark data on the prevalence of undernutrition, including more than half a million patients. One out of 7 patients was scored as undernourished. For geriatrics, oncology, gastroenterology, and internal medicine, this ratio was even greater (1 out of 3–4). Hospital stay was 1.4 d longer among undernourished patients than among those who were well nourished.
Original languageEnglish
Pages (from-to)1026-1032
JournalAmerican journal of clinical nutrition
DOIs
Publication statusPublished - 2016

Keywords

  • malnutrition
  • undernutrition
  • hospitals

Cite this

Jager-Wittenaar, Harriët ; Kruizenga, Hinke ; van Keeken, Suzanne ; Weijs, Peter ; Bastiaanse, Luc ; Beijer, Sandra ; Huisman-de Waal, Getty ; Jonkers-Schuitema, Cora ; Klos, Mariël ; Remijnse-Meester, Wineke ; Witteman, Ben ; Thijs, Abel. / Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer. In: American journal of clinical nutrition. 2016 ; pp. 1026-1032.
@article{7c8a81ee6fea495d9614d56d7ef53947,
title = "Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer",
abstract = "Background: Undernutrition is a common complication of disease and a major determinant of hospital stay outcome. Dutch hospitals are required to screen for undernutrition on the first day of admission. Objective: We sought to determine the prevalence of the screening score “undernourished” with the use of the Short Nutritional Assessment Questionnaire (SNAQ) or Malnutrition Universal Screening Tool (MUST) and its relation to length of hospital stay (LOS) in the general hospital population and per medical specialty. Design: We conducted an observational cross-sectional study at 2 university, 3 teaching, and 8 general hospitals. All adult inpatients aged ≥18 y with an LOS of at least 1 d were included. Between 2007 and 2014, the SNAQ/MUST score, admitting medical specialty, LOS, age, and sex of each patient were extracted from the digital hospital chart system. Linear regression analysis with ln(LOS) as an outcome measure and SNAQ ≥3 points/MUST ≥2 points, sex, and age as determinant variables was used to test the relation between SNAQ/MUST score and LOS. Results: In total, 564,063 patients were included (48{\%} males and 52{\%} females aged 62 ± 18 y). Of those, 74{\%} (419,086) were screened with SNAQ and 26{\%} (144,977) with MUST, and 13.7{\%} (SNAQ) and 14.9{\%} (MUST) of the patients were defined as being undernourished. Medical specialties with the highest percentage of the screening score of undernourished were geriatrics (38{\%}), oncology (33{\%}), gastroenterology (27{\%}), and internal medicine (27{\%}). Patients who had an undernourished screening score had a higher LOS than did patients who did not (median 6.8 compared with 4.0 d; P < 0.001). Regression analysis showed that a positive SNAQ/MUST score was significantly associated with LOS [SNAQ: +1.43 d (95{\%} CI: 1.42, 1.44 d), P < 0.001; MUST: +1.47 d (95{\%} CI: 1.45, 1.49 d), P < 0.001]. Conclusions: This study provides benchmark data on the prevalence of undernutrition, including more than half a million patients. One out of 7 patients was scored as undernourished. For geriatrics, oncology, gastroenterology, and internal medicine, this ratio was even greater (1 out of 3–4). Hospital stay was 1.4 d longer among undernourished patients than among those who were well nourished.",
keywords = "ondervoeding, ziekenhuizen, malnutrition, undernutrition, hospitals",
author = "Harri{\"e}t Jager-Wittenaar and Hinke Kruizenga and {van Keeken}, Suzanne and Peter Weijs and Luc Bastiaanse and Sandra Beijer and {Huisman-de Waal}, Getty and Cora Jonkers-Schuitema and Mari{\"e}l Klos and Wineke Remijnse-Meester and Ben Witteman and Abel Thijs",
year = "2016",
doi = "10.3945/​ajcn.115.126615",
language = "English",
pages = "1026--1032",
journal = "American journal of clinical nutrition",
issn = "0002-9165",
publisher = "American Society for Nutrition",

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Jager-Wittenaar, H, Kruizenga, H, van Keeken, S, Weijs, P, Bastiaanse, L, Beijer, S, Huisman-de Waal, G, Jonkers-Schuitema, C, Klos, M, Remijnse-Meester, W, Witteman, B & Thijs, A 2016, 'Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer' American journal of clinical nutrition, pp. 1026-1032. https://doi.org/10.3945/​ajcn.115.126615

Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer. / Jager-Wittenaar, Harriët; Kruizenga, Hinke; van Keeken, Suzanne; Weijs, Peter; Bastiaanse, Luc; Beijer, Sandra; Huisman-de Waal, Getty; Jonkers-Schuitema, Cora; Klos, Mariël; Remijnse-Meester, Wineke; Witteman, Ben; Thijs, Abel.

In: American journal of clinical nutrition, 2016, p. 1026-1032.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer

AU - Jager-Wittenaar, Harriët

AU - Kruizenga, Hinke

AU - van Keeken, Suzanne

AU - Weijs, Peter

AU - Bastiaanse, Luc

AU - Beijer, Sandra

AU - Huisman-de Waal, Getty

AU - Jonkers-Schuitema, Cora

AU - Klos, Mariël

AU - Remijnse-Meester, Wineke

AU - Witteman, Ben

AU - Thijs, Abel

PY - 2016

Y1 - 2016

N2 - Background: Undernutrition is a common complication of disease and a major determinant of hospital stay outcome. Dutch hospitals are required to screen for undernutrition on the first day of admission. Objective: We sought to determine the prevalence of the screening score “undernourished” with the use of the Short Nutritional Assessment Questionnaire (SNAQ) or Malnutrition Universal Screening Tool (MUST) and its relation to length of hospital stay (LOS) in the general hospital population and per medical specialty. Design: We conducted an observational cross-sectional study at 2 university, 3 teaching, and 8 general hospitals. All adult inpatients aged ≥18 y with an LOS of at least 1 d were included. Between 2007 and 2014, the SNAQ/MUST score, admitting medical specialty, LOS, age, and sex of each patient were extracted from the digital hospital chart system. Linear regression analysis with ln(LOS) as an outcome measure and SNAQ ≥3 points/MUST ≥2 points, sex, and age as determinant variables was used to test the relation between SNAQ/MUST score and LOS. Results: In total, 564,063 patients were included (48% males and 52% females aged 62 ± 18 y). Of those, 74% (419,086) were screened with SNAQ and 26% (144,977) with MUST, and 13.7% (SNAQ) and 14.9% (MUST) of the patients were defined as being undernourished. Medical specialties with the highest percentage of the screening score of undernourished were geriatrics (38%), oncology (33%), gastroenterology (27%), and internal medicine (27%). Patients who had an undernourished screening score had a higher LOS than did patients who did not (median 6.8 compared with 4.0 d; P < 0.001). Regression analysis showed that a positive SNAQ/MUST score was significantly associated with LOS [SNAQ: +1.43 d (95% CI: 1.42, 1.44 d), P < 0.001; MUST: +1.47 d (95% CI: 1.45, 1.49 d), P < 0.001]. Conclusions: This study provides benchmark data on the prevalence of undernutrition, including more than half a million patients. One out of 7 patients was scored as undernourished. For geriatrics, oncology, gastroenterology, and internal medicine, this ratio was even greater (1 out of 3–4). Hospital stay was 1.4 d longer among undernourished patients than among those who were well nourished.

AB - Background: Undernutrition is a common complication of disease and a major determinant of hospital stay outcome. Dutch hospitals are required to screen for undernutrition on the first day of admission. Objective: We sought to determine the prevalence of the screening score “undernourished” with the use of the Short Nutritional Assessment Questionnaire (SNAQ) or Malnutrition Universal Screening Tool (MUST) and its relation to length of hospital stay (LOS) in the general hospital population and per medical specialty. Design: We conducted an observational cross-sectional study at 2 university, 3 teaching, and 8 general hospitals. All adult inpatients aged ≥18 y with an LOS of at least 1 d were included. Between 2007 and 2014, the SNAQ/MUST score, admitting medical specialty, LOS, age, and sex of each patient were extracted from the digital hospital chart system. Linear regression analysis with ln(LOS) as an outcome measure and SNAQ ≥3 points/MUST ≥2 points, sex, and age as determinant variables was used to test the relation between SNAQ/MUST score and LOS. Results: In total, 564,063 patients were included (48% males and 52% females aged 62 ± 18 y). Of those, 74% (419,086) were screened with SNAQ and 26% (144,977) with MUST, and 13.7% (SNAQ) and 14.9% (MUST) of the patients were defined as being undernourished. Medical specialties with the highest percentage of the screening score of undernourished were geriatrics (38%), oncology (33%), gastroenterology (27%), and internal medicine (27%). Patients who had an undernourished screening score had a higher LOS than did patients who did not (median 6.8 compared with 4.0 d; P < 0.001). Regression analysis showed that a positive SNAQ/MUST score was significantly associated with LOS [SNAQ: +1.43 d (95% CI: 1.42, 1.44 d), P < 0.001; MUST: +1.47 d (95% CI: 1.45, 1.49 d), P < 0.001]. Conclusions: This study provides benchmark data on the prevalence of undernutrition, including more than half a million patients. One out of 7 patients was scored as undernourished. For geriatrics, oncology, gastroenterology, and internal medicine, this ratio was even greater (1 out of 3–4). Hospital stay was 1.4 d longer among undernourished patients than among those who were well nourished.

KW - ondervoeding

KW - ziekenhuizen

KW - malnutrition

KW - undernutrition

KW - hospitals

U2 - 10.3945/​ajcn.115.126615

DO - 10.3945/​ajcn.115.126615

M3 - Article

SP - 1026

EP - 1032

JO - American journal of clinical nutrition

JF - American journal of clinical nutrition

SN - 0002-9165

ER -