PP337 - HOSPITAL MALNUTRITION AND ADVERSE CRITICAL CARE OUTCOMES IN SWITZERLAND: FINDINGS FROM 12.2 MILLION ADULT HOSPITALIZATIONS, 2012–2022
PP337
HOSPITAL MALNUTRITION AND ADVERSE CRITICAL CARE OUTCOMES IN SWITZERLAND: FINDINGS FROM 12.2 MILLION ADULT HOSPITALIZATIONS, 2012–2022
A. Tanweer1,2,*, P. Marques Vidal1
1Department of Medicine, Internal medicine, Lausanne University Hospital , University of Lausanne, Lausanne, Switzerland, 2School of health Sciences, Nutrition and Dietetics, University of Management and Technology, Lahore, Pakistan
Rationale: Hospital malnutrition is a major, yet under-recognized clinical problem associated with adverse in-hospital outcomes (1), particularly for patients with greater clinical complexity. However, in Switzerland, national-level evidence after 2014 remains limited (2).
Methods: We conducted a retrospective analysis of the Swiss hospital discharge database for 12,195,344 adult hospitalizations (2012 and 2022). Malnutrition was identified using ICD-10 codes E40–E46 (3). Multivariable logistic regression assessed the associations of malnutrition with ICU admission, in-hospital mortality, and length of stay >5 days. Contribution of documented dietetic consultation to hospital outcomes was further explored using propensity score matching (4).
Results: Overall 4.9% hospitalizations had a documented diagnosis of malnutrition, increasing nearly six-fold in ten years (1.4%-8.1%). Malnutrition was significantly associated with worsened clinical outcomes; higher likelihood of ICU admission (OR 1.70,95% CI 1.68–1.71), in-hospital mortality (1.37, 1.35–1.39), and prolonged hospital stay (8.07,8.00–8.14). 61.9% of malnourished received a dietetic consultation. Propensity score–matched analyses suggested that dietetic consultation attenuated the association of malnutrition with in-hospital mortality (unmatched: 0.86,0.84–0.88;p<0.001 vs matched:0.81,0.65–1.02;p>0.05), while no reduction was observed for ICU admission or prolonged stay.
Conclusion: Hospital malnutrition in Switzerland is strongly associated with critical care utilization, greater mortality, and prolonged hospitalization. These findings support the need for implementing guidelines (5) on systematic malnutrition screening, coding, and timely nutrition intervention.
References: 1. 10.1016/S0140-6736(21)01451-3
3. https://icd.who.int/browse10/2019/en
4. 10.1093/ajcn/nqab135
5. 10.1016/j.clnu.2021.09.039
Disclosure of Interest: None declared