SHM Converge Scientific Abstract ePoster Gallery-An Epidemic of Malnutrition? A Trends Study of Hospitaliations.

Pdf Summary

This trends study examined U.S. adult general medical hospitalizations from 2016 to 2019 using the National Inpatient Sample to assess how often malnutrition was diagnosed and how related outcomes changed over time. Hospitalizations were classified by ICD-10 codes into no malnutrition, non-severe malnutrition, or severe malnutrition. Outcomes included invasive mechanical ventilation, PEG-tube placement, and death, with rates adjusted for age, sex, and comorbidities.<br /><br />Among 66.3 million hospitalizations, 7.8% had a malnutrition diagnosis: 3.7% non-severe and 4.1% severe. Overall malnutrition diagnoses increased 29% during the study period, rising from 6.64% of cases in 2016 to 8.55% in 2019. The increase was driven by a 44% rise in severe malnutrition diagnoses, from 3.3% to 4.7%.<br /><br />However, among hospitalizations coded as severe malnutrition, adjusted mortality declined over time, from 12.2% in 2016 to 10.6% in 2019, with a significant downward trend. Mechanical ventilation also decreased somewhat, while PEG-tube placement remained roughly stable. These declining severity and mortality trends were not seen in hospitalizations without malnutrition.<br /><br />The authors conclude that the rising prevalence of malnutrition coding may reflect changes in coding practices, a lower threshold for assigning the diagnosis, or labeling of patients who previously would not have been identified as malnourished. Because severe malnutrition affects reimbursement and risk adjustment, the findings raise concerns about the vagueness and subjectivity of current diagnostic criteria. Further research is needed to clarify how severe malnutrition should be defined in acute illness.

Asset Subtitle

Ajay Bhasin

Meta Tag

Author List Ajay Bhasin, Lynn Huang, Meng-Shiou Shieh, Penelope Pekow, Peter Lindenauer, Tara Lagu

Category Research

Concept Malnutrition

Concept Severe Malnutrition

Concept Hospitalization

Concept ICD-10 Classification

Concept Mortality

Distinguished Non-Finalist

Presenter Organization Northwestern Feinberg School of Medicine

Presenting Author Ajay Bhasin

Track Outcomes Research

Keywords

malnutrition

hospitalization trends

National Inpatient Sample

ICD-10 coding

severe malnutrition

adult medical admissions

mortality decline

mechanical ventilation

PEG-tube placement

risk adjustment

Malnutrition

Severe Malnutrition

Hospitalization

ICD-10 Classification

Mortality