Evidence map›Paper›PMID 39705746›Full record

ArticleThe journal of nutrition, health & aging2025

Increased risk of rehospitalisation and death in older hospital patients at risk of malnutrition: A cohort study.

Kristin I Folven, Eva Biringer, Roy M Nilsen, Anne Marie Beck, Kari Sygnestveit, Eli Skeie, Øystein Hetlevik, Randi J Tangvik

Abstract read
In one paragraph

Article in The journal of nutrition, health & aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kristin I FolvenDepartment of Research and Innovation, Fonna Hospital Trust, P.O. Box 2170, NO-5504 Haugesund, Norway; Centre for Nutrition, Department of Clinical Medicine, University of Bergen, P.O. Box 7804, NO-5020 Bergen, Norway. Electronic address: kristin.folven@helse-fonna.no.
Eva BiringerDepartment of Research and Innovation, Fonna Hospital Trust, P.O. Box 2170, NO-5504 Haugesund, Norway.
Roy M NilsenFaculty of Health and Social Sciences, Western Norway University of Applied Sciences, P.O. Box 7030, NO-5020 Bergen, Norway.
Anne Marie BeckUnit for Dieticians and Nutrition Research, Herlev and Gentofte University Hospital, DK-2730 Herlev, Denmark.
Kari SygnestveitDepartment of Research and Development, Haukeland University Hospital, Bergen, Norway; Norwegian National Advisory Unit on Disease Related Undernutrition, Oslo University Hospital, Oslo, Norway.
Eli SkeieDepartment of Health and Social Services, Kvam Municipality, Norheimsund, Norway.
Øystein HetlevikDepartment of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, P.O. Box 7804, NO-5020 Bergen, Norway.
Randi J TangvikCentre for Nutrition, Department of Clinical Medicine, University of Bergen, P.O. Box 7804, NO-5020 Bergen, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aim of the study was to investigate associations between risk of malnutrition and risk of rehospitalisation and death in older hospital patients, and whether the possible associations were modified by age, gender, comorbidity or Ambulatory Care Sensitive Conditions (ACSCs).

designProspective cohort study.

settingSomatic hospital in Western Norway.

participants9,768 hospital admissions for patients aged ≥65 years. MEASUREMENTS: Information on the risk of malnutrition was based on nutritional risk screening data from 34 point prevalence surveys conducted between 2008 and 2018. Risk of malnutrition was assessed using Nutritional Risk Screening 2002 (NRS 2002) during the initial hospital admission. Outcomes and possible effect modifiers were obtained from the hospital's patient administration systems. The short-term outcome was the length of initial hospital stay. Long-term outcomes included total number of days in hospital, number of hospital stays and risk of death within one year following nutritional risk screening. Statistical analysis involved negative binomial and Cox regression models with adjustment for age, sex and number of diagnoses at time of nutritional risk screening.

resultsOverall, 34% of the patients were classified as being at risk of malnutrition. A higher proportion of the initial admissions were related to ACSCs for patients at risk of malnutrition than for those not at risk. Risk of malnutrition was associated with longer initial hospital stay (adjusted hazard ratio (95% confidence intervals) 1.31 (1.25, 1.37)), more days in hospital (adjusted risk ratio 1.25 (1.18, 1.32)) and a higher risk of having more than two hospital admissions the year following nutritional risk screening (adjusted risk ratio 1.16 (1.07, 1.26)). Patients at risk of malnutrition also had an increased risk of death within one year (adjusted hazard ratio 2.45 (2.25, 2.67)). All associations were more pronounced in the '65-69' and '70-79' age groups compared to the 80+ years age group, and in patients with fewer than four diagnoses compared to patients with four or more diagnoses. No significant interaction was detected between sex and risk of malnutrition with regard to patient outcomes.

conclusionOlder patients at risk of malnutrition have a higher risk of rehospitalisation and death during the first year after nutritional risk screening compared with those not at risk. Among patients at risk of malnutrition, the initial hospital admissions were more often due to ACSCs. The impact of the risk of malnutrition on outcomes appears stronger in patients aged 65-79 years and in patients with less comorbidity. These findings underline the importance of nutritional risk screening and subsequent nutritional support in all groups of older patients.

Indexed as

MalnutritionPatient ReadmissionAgedAged, 80 and overCohort StudiesFemaleGeriatric AssessmentHospitalizationHumansLength of StayMaleNorwayNutrition AssessmentProspective StudiesRisk AssessmentRisk FactorsAgedHealth servicesHospitalsMortalityNutritional statusNutrition assessment

Identifiers

PMID39705746
PMCPMC12180037

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.