Logo do repositório
 
Publicação

Missed opportunities in nutritional care: prevalence, mortality, and resource utilization in internal medicine wards

2026-05Artigo científico Acesso aberto
Ver registo simples
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorMarinho, Ricardo C.
dc.contributor.authorCraveiro, Ana
dc.contributor.authorFerreira, Susana
dc.contributor.authorCarolino, Elisabete
dc.contributor.authorLopes, Marta S.
dc.contributor.authorCorreia, João A.
dc.contributor.authorMarinho, Anibal
dc.contributor.authorSantos, Marisa D.
dc.date.accessioned2026-06-03T10:43:14Z
dc.date.available2026-06-03T10:43:14Z
dc.date.issued2026-05
dc.description.abstractBackground: Malnutrition is a highly prevalent and underdiagnosed condition among hospitalized patients, especially in internal medicine wards. Hospital malnutrition is associated with increased morbidity, mortality, prolonged admissions, and a substantial economic burden. Objectives: This study aimed to assess the clinical and economic impact of nutritional risk in patients admitted to internal medicine wards, focusing on mortality, hospital resource utilization, and the effectiveness of nutritional interventions. Methods: A retrospective cohort study was conducted at ULS Santo António, Porto, including 1,150 hospital admissions from January to December 2022. All adult patients with nutritional risk screening (NRS-2002) in the first 48 h of admission were included. Data were collected from hospital information systems on demographic, clinical, and economic variables, with outcomes including in-hospital mortality, readmissions at 30, 90, and 180 days, and one-year post-discharge mortality. Results: Nutritional risk (NRS-2002 ≥ 3) was identified in 42.4% of patients (n = 488), while ICD-10 malnutrition coding at discharge was recorded in only 0.7% of admissions. Of patients at nutritional risk, 74.4% (n = 363) received no nutritional supplementation. Nutritional risk was associated with higher in-hospital mortality, longer length of stay, and increased costs across all resource categories. In the time-dependent Cox model, patients at nutritional risk without supplementation showed a markedly higher hazard of in-hospital death at admission (HR 23.32, 95% CI 13.09-41.56), with this excess hazard attenuating over time. Patients at nutritional risk who received supplementation also showed elevated early risk (HR 6.15, 95% CI 2.96-12.80), though lower than unsupplemented patients. A similar pattern was observed for one-year post-discharge mortality. Total hospitalization costs were approximately 79% higher in at-risk patients, driven mainly by longer length of stay. Conclusion: Nutritional risk affected 42.4% of internal medicine inpatients and was associated with higher mortality and resource use. The finding that 74.4% of at-risk patients received no nutritional intervention represents a substantial missed opportunity. Patients who received nutritional supplementation showed a pattern of lower mortality risk than unsupplemented at-risk patients, consistent with but not proving a beneficial association. These findings support systematic nutritional screening and timely intervention in hospital care.eng
dc.identifier.citationMarinho RC, Craveiro A, Ferreira S, Carolino E, Lopes MS, Correia JA, et al. Missed opportunities in nutritional care: prevalence, mortality, and resource utilization in internal medicine wards. Front Nutr. 2026;13:1755750.
dc.identifier.doi10.3389/fnut.2026.1755750
dc.identifier.issn2296-861X
dc.identifier.urihttp://hdl.handle.net/10400.21/22909
dc.language.isoeng
dc.peerreviewedyes
dc.publisherFrontiers Media SA
dc.relation.hasversionhttps://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2026.1755750/full
dc.relation.ispartofFrontiers in Nutrition
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectNRS-2002
dc.subjectHealth costs and outcomes
dc.subjectHealth economics
dc.subjectHospital
dc.subjectMortality
dc.subjectInternal medicine
dc.subjectMalnutrition
dc.subjectNutritional risk
dc.subjectReal-world evidence
dc.titleMissed opportunities in nutritional care: prevalence, mortality, and resource utilization in internal medicine wardseng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Nutrition
oaire.citation.volume13
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameCarolino
person.givenNameElisabete
person.identifier.orcid0000-0003-4165-7052
relation.isAuthorOfPublication31223136-1531-4060-aec7-4d3fc8529916
relation.isAuthorOfPublication.latestForDiscovery31223136-1531-4060-aec7-4d3fc8529916

Ficheiros

Principais
A mostrar 1 - 1 de 1
Miniatura
Nome:
Missed opportunities in nutritional care_prevalence, mortality, and resource utilization in internal medicine wards.pdf
Tamanho:
433.3 KB
Formato:
Adobe Portable Document Format
Ver/Abrir
Licença
A mostrar 1 - 1 de 1
Miniatura indisponível
Nome:
license.txt
Tamanho:
4.03 KB
Formato:
Item-specific license agreed upon to submission
Descrição:
Ver/Abrir

Coleções

ESTeSL - Artigos