Does the Mini Nutritional Assessment predict hospitalization outcomes in older people?

Background: the Mini Nutritional Assessment is a validated clinical tool for the assessment of nutritional status in older people. Moderate to severe malnutrition is common in elderly patients in hospital and is associated with a poor outcome. Objectives: to determine whether the Mini Nutritional Assessment can predict the outcome of hospital stay in older individuals. Setting: a tertiary‐care geriatric hospital. Methods: we evaluated nutritional status using the Mini Nutritional Assessment in 1319 patients (mean age 84.2, 70% women) admitted between February 1996 and January 1998; 1145 complete assessments were available for analysis. The assessment was carried out on admission and studied in relation to length of stay and in‐hospital mortality for all patients, and discharge to a nursing home for those living at home before admission. Results: Mini Nutritional Assessment scores averaged 19.9±3.8 (mean±SD) with a range of 8.0-27.5, and a median of 20.5. A score below 17, corresponding to malnutrition, was associated with an almost threefold increase in mortality and in the rate of discharge to a nursing home; this contrasted with a score above 24, which indicates satisfactory nutritional status (11.3% vs 3.7%; P<0.01 and 20.3% vs 7.7%; P<0.001, respectively). Length of stay was longer in the low scoring group (42.0 days vs 30.5 days; P<0.0002). Conclusion: Poor nutritional status as measured by the Mini Nutritional Assessment was associated with increased in‐hospital mortality, a higher rate of discharge to nursing homes and a longer length of stay