PD486 - THE NUTRITIONAL STATUS OF ADULT AND ELDERLY PATIENTS ADMITTED TO HOSPITALS OF THE MINISTRY OF PUBLIC HEALTH

PD486

THE NUTRITIONAL STATUS OF ADULT AND ELDERLY PATIENTS ADMITTED TO HOSPITALS OF THE MINISTRY OF PUBLIC HEALTH

P. Chuntupama^1,*, T. Chompoosaeng², S. Subwongcharoen¹

¹Surgery, ²Rajavithi Hospital, Bangkok, Thailand

Rationale: In-hospital malnutrition is associated with adverse outcomes, yet large-scale real-world data from Southeast Asia remain scarce. This study examined the association between nutritional status and length of stay (LOS), medical costs and in-hospital mortality.

Methods: A cross-sectional study in adult inpatients (age ≥18y) was conducted across 33 hospitals covering all regions of Thailand. Nutritional status was assessed by the Nutrition Alert Form (NAF), a validated tool for Thai patients, and categorized as NAF-A (mild/normal), NAF-B (moderate), and NAF-C (severe malnutrition). Outcomes were compared across NAF categories using Kruskal-Wallis, one-way ANOVA, and Chi-square tests. The study was approved by the Human Research Ethics Committee, Rajavithi Hospital, Bangkok, Thailand.

Results: Screening was conducted on 29.6% (193,730) of the 653,288 total inpatients, with 39,129 identified as at-risk. From the total screened cohort, 39,562 patients were assessed, revealing 9,424 (4.86%) mild, 13,892 (7.17%) moderate, and 16,029 (8.27%) severe malnutrition cases. Increased malnutrition severity significantly correlated with poorer outcomes: increasing median LOS from 7 days [IQR 3-17] to 12 days [IQR 6-24], raising median medical costs from 41,930 THB [IQR 13,000-115,406] to 82,715 THB [IQR 31,628-189,051], and elevating mortality risk from 2.3% to 23.6% (comparing NAF-A with NAF-C), all pairwise p<0.001. These adverse outcomes were even more pronounced among elderly patients (aged >60 years).

Conclusion: Conclusion: Nationwide big data confirms that malnutrition significantly burdens the Thai healthcare system through increased mortality, costs, and LOS. These findings justify mandatory screening and the integration of nutritional support into national healthcare quality indicators and reimbursement frameworks to optimize patient outcomes.

Disclosure of Interest: None declared