Mini nutritional assessment (MNA) as nutrition screening tool in internal medicine. Advantages and disadvantages

Objective: To evaluate the nutritional status of the elderly hospitalized patient with the Mini Nutritional Assessment (MNA), its relationship with length of hospital stay and mortality, the incidence of malnutrition during hospitalization and to evaluate the applicability of MNA in an Internal Medicine Department of an acute care hospital. Material and methods: A prospective study on the nutritional status of patients of 65 years or older admitted to hospital in an Internal Medicine Department was performed in 106 consecutive patients. In all patients a MNA test, an anthropometric (weight, height, body mass index, skinfold), and biochemical (cholesterol, lymphocytes, albumin) evaluation were performed; outcome, age, institutionalization, Charlson index and Barthel index were recorded. Results: Mean age of the patients was 81 +/- 7 years, Charlson index 2.3 +/- 1.9 and Barthel index 74.9 +/- 30.8. Mean weight was 64.5 +/- 10.6 kg, BMI 26 +/- 3.9, and weight loss in the previous 3 months 1.17 +/- 2.92 kg. Mean length of hospital stay was 11.1 +/- 9.8, and mortality was 5.7%. Prevalence of malnutrition, assessed by MNA, was 4.7%, and 36.8% of the patients were at risk of malnutrition. Malnourished patients have a longer length of hospital stay, higher Barthel and Charlson indexes. There are no conclusive differences in mortality. Incidence of malnutrition during hospitalization was between 2.43 and 15.68%. Conclusions: Malnutrition increases length of hospital stay, rate of complications and costs. The clinicians responsible for the patient should perform nutrition evaluation at hospital admission and repeat it during the hospitalization, using simple screening tools that incorporate an explicit nutrition intervention plan. (C) 2009 Elsevier Espana, S.L. All rights reserved.