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Am J Clin Nutr. 2002 Feb;75(2):308-13.

Malnutrition in subacute care.

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  • 1Division of Geriatric Medicine, St Louis Health Sciences Center and The Geriatric Research, Education, and Clinical Center, St Louis Veterans Administration Medical Center, MO 63104, USA.



Dramatic weight loss and hypoalbuminemia often follow acute hospitalization.


The objective was to examine the prevalence of undernutrition in a subacute-care facility.


We evaluated 837 patients consecutively admitted over 14 mo to a 100-bed subacute-care center. Nutritional status was assessed by anthropometric measurements, biochemical markers, and a Mini Nutritional Assessment (MNA) score. Primary outcome measures included length of stay and death. Secondary measures included readmission to an acute-care hospital and placement at discharge.


The subjects' mean (+/- SD) age was 76 +/- 13 y and 61% were women. Eighteen percent of the subjects had a body mass index (in kg/m(2)) <19. With the use of 35 g/L as a cutoff, 53% of the subjects had hypoalbuminemia. Only 8% of the subjects were classified as being well nourished according to the MNA. Almost one-third (29%) of the subjects were malnourished and almost two-thirds (63%) were at risk of malnutrition. Thus, >91% of subjects admitted to subacute care were either malnourished or at risk of malnutrition. The Geriatric Depression Score was higher in malnourished subjects than in nutritionally at-risk subjects (P = 0.05). Length of stay differed by 11 d between the malnourished group and the nutritionally at-risk group (P = 0.007). In the MNA-assessed group of largely malnourished subjects, 25% of subjects required readmission to an acute-care hospital compared with 11% of the well-nourished group (P = 0.06). Mortality was not found to be related to BMI.


Malnutrition reaches epidemic proportions in patients admitted to subacute-care facilities. Whether this reflects nutritional neglect in acute-care hospitals or is the result of profound illness is unclear. Nevertheless, strict attention to nutritional status is mandatory in subacute-care settings.

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