The Effect of a Digital Energy- and Protein-Dense Food Concept with a Nutritional Tracker on Dietary Intake in Hospitalized Patients at Nutritional Risk - A one-day Cross-Sectional Study

BACKGROUND & AIMS: A one-day cross-sectional study conducted at our hospital in 2019 found low achieved intake of energy and protein requirement among nutritional at-risk patients. Since then, a new energy and protein-dense digital food concept with a nutritional tracker to actively involve patients in their nutrition has been introduced. This study aimed to assess improvements in energy and protein intake, evaluate the performance of nutritional risk screening and documentation, examine hospital length of stay (LOS), prevalence of malnutrition, and rates of mortality and readmission.

METHODS: A one-day cross-sectional study was performed in September 2023. Patients ≥18 years and hospitalized for ≥4 days were enrolled.

EXCLUSION CRITERIA: admission to the intensive, palliative, emergency, or maternal ward. Patients identified as at nutritional risk by the Nutritional Risk Screening tool (NRS-2002) underwent a 24-h dietary recall to evaluate their nutritional intake and adequacy. Malnutrition was assessed using the criteria of Global Leadership Initiative on Malnutrition (GLIM). Additional data were collected from the electronic medical records.

RESULTS: Out of 124 patients (52 % female) with a median age of 75 years (Interquartile Range (IQR): 66-83), 81 (65 %) were at nutrition risk. Dietary intake was assessed for 69 at-risk patients. Compared to 2019, more patients met 75 % of their energy (70 % vs. 35 %, p < 0.001) and protein (51 % vs. 24 %, p < 0.001) requirements. Energy and protein intake was documented for 42 % of patients but was inaccurate documented. Only 25 % were nutritionally screened within 24 h of admission. Among at-risk patients, 74 % (n = 58) were diagnosed with malnutrition. LOS was 13 days (IQR: 9-21), with readmission and mortality rates of 39 % and 22 %, respectively. No significant difference in LOS, readmission and mortality was found between nutritional at-risk and not at-risk patients.

CONCLUSIONS: The study indicated that actively involving nutritional at-risk patients in their own nutrition effectively increased energy and protein intake. The study revealed significant gaps in nutritional documentation and a high prevalence of malnutrition according to the GLIM criteria.