PREVALÊNCIA, FATORES DE RISCO E DESFECHOS CLÍNICOS ASSOCIADOS À DESNUTRIÇÃO EM PACIENTES HOSPITALIZADOS

Abstract

The high prevalence of hospital malnutrition, whether as a cause or consequence of worsening clinical conditions, has been reported as a significant public health issue in several countries, particularly due to its association with adverse outcomes such as longer hospital stays and increased healthcare costs. In this context, the aim of this study was to analyze the prevalence of malnutrition, its risk factors, and the association between changes in nutritional status and clinical outcomes in hospitalized patients. To this end, two studies were conducted: an integrative literature review and a descriptive study in a public hospital in São Luís, Maranhão, Brazil. The first study consisted of a literature review based on the MEDLINE, SciELO, LILACS, Google Scholar, and Web of Science databases, including 16 studies published between 2019 and 2024. Subsequently, a descriptive, cross-sectional, and quantitative study was carried out, involving 80 patients aged between 18 and 87 years, hospitalized in general wards of a public hospital. Data collection occurred in three stages: (a) review of medical records; (b) bedside questionnaire to screen for nutritional information and identify risk factors associated with malnutrition; and (c) nutritional status assessment using Body Mass Index (BMI) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. The data were tabulated and statistically analyzed using SPSS software. The literature review revealed malnutrition prevalence rates ranging from 15,3% to 65,1% across different regions of Brazil. Reported risk factors for hospital malnutrition included advanced age, low educational level, poor dietary intake, presence of symptoms such as nausea, vomiting, anorexia, and dysphagia, as well as prolonged length of hospital stay. In the descriptive study, the overall prevalence of malnutrition according to GLIM criteria was 58,8%, with a significant difference between adults (46,8%) and older adults (72,7%) (p=0,011). Low BMI was strongly associated with malnutrition according to GLIM criteria in both adults (p=0,003) and older adults (p=0,002). The most prevalent risk factors were unintentional weight loss in the previous three months (51,3%) and decreased appetite during hospitalization (51,3%). The average length of stay among malnourished patients was 32,5 days (± 18,6). Moreover, these patients showed a higher likelihood of adverse outcomes, such as death (75%) and transfer to the Intensive Care Unit (17,4%) (p=0,047). These findings highlight that malnutrition is a highly prevalent condition in the hospital setting, with significant clinical implications. Therefore, early nutritional risk screening and comprehensive nutritional assessment are essential for the development of effective treatment and prevention protocols during hospitalization, aiming to reduce nutritionrelated complications.