Internal and Emergency Medicine

, Volume 14, Issue 1, pp 51–57 | Cite as

May nutritional status worsen during hospital stay? A sub-group analysis from a cross-sectional study

  • Emanuele RinninellaEmail author
  • Marco Cintoni
  • Antonino De Lorenzo
  • Gaia Anselmi
  • Lucilla Gagliardi
  • Giovanni Addolorato
  • Giacinto Abele Donato Miggiano
  • Antonio Gasbarrini
  • Maria Cristina Mele


Hospital malnutrition is a detrimental prognostic factor regarding hospital mortality, complications, and length of stay. However, the role of hospitalization itself on nutritional status has not been fully elucidated. We report the results of a secondary analysis from the dataset of a recent cross-sectional study at Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Data from patients evaluated at admission and discharge were collected and compared. One hundred thirty-nine patients were evaluated. Mean length of stay was 13.6 (± 7.7) days. Patients at risk of malnutrition, according to NRS-2002, were 75 (53.9%), while 63 (45.3%) were malnourished according to ESPEN Criteria. Compared to admission, at discharge, patients reported a significant decrease in Mid-Upper Arm Circumference (MUAC)—from 26.5 cm (± 3.6) to 25.9 cm (± 3.7) (p = 0.016), a reduction in Phase angle (PhA)—from 4.25° (± 1.20) to 4.01° (± 1.15) (p = 0.005), fat-free mass (FFM)—from 47.5 kg (± 9.19) to 44.9 kg (± 9.4) (p = 0.03) and fat-free mass index (FFMI)—from 16.9 kg/m2 (± 2.3) to 15.8 kg/m2 (± 2.7) (p = 0.04). Laboratory data showed a reduction of albumin—from 29.2 (± 5.7) to 28.0 (± 5.9) (p = 0.01) and Onodera’s PNI- from 29.1 (± 5.6) to 27.6 kg (± 5.6) (p = 0.039). At the multivariate linear regression analysis, the variables significantly associated with a worsening of PhA at discharge are the PhA value at admission and the diagnosis of malnutrition according to ESPEN Criteria. Hospitalization leads to significative changes in nutritional status. A clinical concern should be raised about the quality of hospital food and meal times and on the need for a clinical nutritionist on the ward.


Nutritional status Hospital malnutrition Phase angle Fat-free mass Prognostic nutritional index ESPEN criteria Personalized medicine 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The study was carried out according to Declaration of Helsinki and obtained the approval of the local Ethics Committee (Fondazione Policlinico A. Gemelli). Protocol number 53572/17.

Informed consent

Patients gave their informed consent to participate to the survey.


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Copyright information

© Società Italiana di Medicina Interna 2018

Authors and Affiliations

  • Emanuele Rinninella
    • 1
    • 2
    Email author
  • Marco Cintoni
    • 1
    • 3
  • Antonino De Lorenzo
    • 4
  • Gaia Anselmi
    • 2
  • Lucilla Gagliardi
    • 1
  • Giovanni Addolorato
    • 1
    • 2
  • Giacinto Abele Donato Miggiano
    • 1
    • 2
  • Antonio Gasbarrini
    • 1
    • 2
  • Maria Cristina Mele
    • 1
    • 2
  1. 1.UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-UrologicheFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
  2. 2.Istituto di Patologia Speciale MedicaUniversità Cattolica del Sacro CuoreRomeItaly
  3. 3.Scuola di Specializzazione in Scienza dell’AlimentazioneUniversità di Roma Tor VergataRomeItaly
  4. 4.Sezione di Nutrizione Clinica e Nutrigenomica, Dipartimento di Biomedicina e PrevenzioneUniversità di Roma Tor VergataRomeItaly

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