LB075 - SELF-RATED HEALTH, COMORBIDITY BURDEN, AND NUTRITIONAL INTAKE AS PREDICTORS OF HOSPITAL MORTALITY: PORTUGAL VERSUS EUROPE IN THE NUTRITIONDAY DATABASE

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LB075

SELF-RATED HEALTH, COMORBIDITY BURDEN, AND NUTRITIONAL INTAKE AS PREDICTORS OF HOSPITAL MORTALITY: PORTUGAL VERSUS EUROPE IN THE NUTRITIONDAY DATABASE

R. C. Marinho1,2,*, S. Tarantino3,4, M. S. Lopes5, E. Carolino6, F. Trumshi3, E. Softic3, C. Schuh7, A. Marinho1,2, M. Hiesmayr3

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, Porto, Portugal, 3Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, 4Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria, 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, Portugal, 7ITSC Medical University of Vienna, Vienna, Austria

 

Rationale: Patient self-rated health (SRH) integrates functional reserve and disease burden in a single patient-reported measure. We aimed to assess the independent impact of SRH, comorbidity burden, and nutritional intake on hospital mortality in Portugal versus Europe using the nutritionDay database.

Methods: Cross-sectional analysis of nutritionDay data (2016 onward; n=31,164). Comorbidity burden was categorised as 0, 1, 2, 3, 4, or ≥5 conditions.  Multivariable logistic regression adjusted for age, sex, BMI, mobility, SRH, lunchtime food intake, ICU admission, and surgical status, stratified by region (Europe n=28,864; Portugal n=2,300).

Results: In-hospital mortality was 2.9% in Europe and 7.3% in Portugal. SRH showed a dose-response relationship with mortality in both cohorts: "very poor" health OR 4.67 (95%CI 3.35–6.51) in Europe and OR 4.46 (95%CI 1.52–13.05) in Portugal. Comorbidity burden was independently associated with mortality in a parallel gradient (Europe ≥5 comorbidities OR 2.36, 95%CI 1.56–3.58; Portugal 4 comorbidities OR 3.44, 95%CI 1.08–10.94). Eating nothing at lunchtime (OR 2.81, 95%CI 2.08–3.81) and unintentional weight loss (OR 1.94, 95%CI 1.48–2.53) were independent nutritional predictors in Europe. Bedridden status was the strongest functional predictor in both regions (Europe OR 3.29; Portugal OR 4.26).

Conclusion: Comorbidity burden, SRH  and reduced food intake are independent predictors of hospital mortality across both settings. The higher observed mortality in Portugal is likely amplified by limited post-acute transfer capacity — substantially fewer patients are discharged to long-term care or rehabilitation compared to Europe — retaining higher-risk patients in acute hospitals. Simple patient-reported measures carry independent prognostic value and should be incorporated into routine nutritional risk assessment.

Disclosure of Interest: None declared