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.