October 24, 2013

Rose Ann DiMaria-Ghalili, PhD, an associate professor in the College of Nursing and Health Professions’ Division of Graduate Nursing, presented a webinar entitled “Characteristics of Hospitalized Patients with Malnutrition” on September 23 to kick off Malnutrition Awareness Week. As a member of the Malnutrition Committee for the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), DiMaria-Ghalili sought to inform fellow clinicians about the increasing prevalence of malnutrition among hospitalized adult patients.

DiMaria-Ghalili is conducting research to better understand national malnutrition rates among hospitalized patients, though this is challenging because malnutrition screenings are different from hospital to hospital, thus requiring her research group to look at coding and billing for the information. “The problem is that we do not have national prevalence rates for malnutrition in the United States, and without that benchmark, we do not fully understand the rate of malnutrition among patients,” explained DiMaria-Ghalili.

As a result, the Malnutrition Committee is trying to generate prevalence rates by studying patient samples provided by the Healthcare Costs and Utilization Project (HCUP), a large federal data pool that shows discharge information for patients who may have had some form of malnutrition. Approximately 1,051 hospitals are included in the data, which represents a 20% stratified sample. Furthermore, the committee defined malnutrition according to hospital coders and how they bill for malnutrition. “This information gives us a general overview of rates, although rates are probably higher, because not all hospitals bill for malnutrition in their coding,” DiMaria-Ghalili said.

The study found that there was a 3.2% rate of malnutrition among hospitalized adults, which corresponds with approximately 1.2 million patients whose average age is 64.8 years old. The demographic data was of particular interest to DiMaria-Ghalili since it jives with her research interests related to malnutrition in elder adults. “We learned that this is a big issue. The average length of stay for patients with malnutrition is 12.6 days as compared to 4.4 days for patients without malnutrition. Of course, this data is only based on coding, so it is still very general,” elaborated DiMaria-Ghalili. She also added that screening for malnutrition differed nationally between hospitals, so there is no clear methodology to conduct appropriate screening.

A.S.P.E.N and DiMaria-Ghalili are advocating for standardized screening procedures in order to set the most accurate national benchmark possible.