PP028 - COMORBIDITY BURDEN AS A DRIVER OF MALNUTRITION AND MORTALITY IN HOSPITALISED INTERNAL MEDICINE PATIENTS

PP028

COMORBIDITY BURDEN AS A DRIVER OF MALNUTRITION AND MORTALITY IN HOSPITALISED INTERNAL MEDICINE PATIENTS

R. C. Marinho^1,2,*, R. Pereira³, A. Craveiro⁴, S. Ferreira⁴, M. S. Lopes⁵, E. Leitão¹, C. Guimarães¹, E. Carolino⁶, A. Marinho^1,2, J. A. Correia^2,3, M. D. Santos^2,7

¹Intensive Care, Centro Hospitalar Universitário de Santo António, Unidade Local de Saúde de Santo António, ²ICBAS School of Medicine and Biomedical Sciences, University of Porto, ³Medicine , ⁴Centro Hospitalar Universitário de Santo António, Unidade Local de Saúde de Santo António, Porto , ⁵Unidade Local de Saúde Entre Douro e Vouga, Feira, ⁶H&TRC – Health & Technology Research Center, ESTeSL – Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, ⁷Colorretal Surgery Unit, Surgery Department, , Centro Hospitalar Universitário de Santo António, Unidade Local de Saúde de Santo António, Porto , Portugal

Rationale: Disease-related malnutrition is highly prevalent in Internal Medicine inpatients and frequently coexists with multimorbidity, but the interplay between comorbidity burden, nutritional status and prognosis remains insufficiently characterised. We evaluated this association and its impact on short- and long-term mortality in polymorbid adults.

Methods: Prospective longitudinal study of 525 consecutive adults admitted to an Internal Medicine ward (February–December 2024). Nutritional risk (NRS-2002) was assessed within 48 hours of admission; GLIM criteria were applied to patients with NRS≥3 using phenotypic (reduced muscle mass by bioimpedance) and aetiologic criteria. Age-adjusted Charlson Index was used for Comorbidity burden. Outcomes were in-hospital and 1-year post-discharge mortality. Group comparisons and chi-square tests explored associations, and time-dependent Cox models assessed independent prognostic effects.

Results: Patients were elderly (mean age 77,5±14,0 years), predominantly low‑educated, with functional impairment (Barthel 66,8±33,2) and high comorbidity burden (Charlson 6,48±2,76). Nutritional risk was present in 49,7%(n=261), and 32,0%(n=168) were malnourished by GLIM. At‑risk patients had higher Charlson scores (6,93 vs 6,04; p=0,001). Each additional Charlson point increased in‑hospital mortality hazard by 14,3% and 1‑year mortality by 9,0% (both p≤0,003). Patients with malnutrition by GLIM had a 4,1‑fold higher in‑hospital mortality hazard versus those without nutritional risk (HR 4,054; 95% CI 1,964–8,369).

Conclusion: In polymorbid Internal Medicine inpatients, comorbidity burden is closely linked to nutritional risk and GLIM‑defined malnutrition and independently predicts in‑hospital and 1‑year mortality, supporting integration of Charlson‑based multimorbidity assessment into routine nutritional screening and targeted intervention.

Disclosure of Interest: None declared