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 < .01; and 20.3% vs 7.7%, p < .001, respectively). Length of stay was longer in the low scoring group (42.0 days vs 30.5 days, p < .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.