Low diagnosis and treatment rates of malnutrition among hospitalized patients in Germany: a nationwide analysis

Introduction: Malnutrition affects 20-30% of hospitalized patients and is associated with increased morbidity and mortality. Mandatory general screening for malnutrition upon hospital admission is still not established in Germany. Representative real-world data about diagnosis and treatment for malnutrition in German hospitals are lacking. Aim of this study is to analyse a German claims database to gather comprehensive data on malnutrition among hospitalized patients in Germany.

Methods: A nationwide anonymised, representative claims database (InGef) was analysed for epidemiological data about patients with diagnosis of malnutrition, defined by ICD codes (E43, E44, E46) from 2017 to 2022. Treatment of malnutrition was defined by OPS (8-015, 8-016, 8-017, 8-018).

Results: The mean prevalence of diagnosed malnutrition for the German population was estimated at 273 per 100,000 based on the claims database, while the mean incidence was only marginally lower with 221 per 100,000. The proportion of hospitalized patients diagnosed with malnutrition was exceptional low, accounting for just 1.26% of cases (9193 out of 730,637). Furthermore, only a minority of hospitalised patients received treatment after being diagnosed with malnutrition (3.73%), while the large majority of patients (96.27%) are not treated. Patients receiving treatment were younger, with a mean age of 66.6 years, compared to patients without treatment, who had a mean age of 74.4 years. Among treated patients, the most frequent main inpatient diagnoses included neoplasia, gastrointestinal diseases, infectious diseases, and respiratory diseases. Non-treated patients most commonly presented with neoplasia, injuries and other external causes, cardiovascular diseases, and gastrointestinal diseases. The admission departments for patients receiving treatment were most frequently Internal Medicine, General Surgery, Hematology and Oncology, and Gastroenterology. Whereas non-treated patients were primarily admitted to the Internal Medicine, Geriatrics, General Surgery, and Trauma Surgery.

Discussion: Real-world data revealed a notably low rate of diagnosed malnutrition in German hospitals, which might indicate a huge rate of missed patients with malnutrition. Furthermore, the rate of initiated treatment among diagnosed patients was alarmingly low. These data underscore the urgent need for implementing structured nutrition care in German hospitals to significantly enhance patient care.

präsentiert in der Sitzung: Ernährung in Klinik und Praxis: Was sollte ich wissen?

Freitag, 04. Oktober 2024, 15:00 – 16:30, Saal 3

Publication History

Article published online:
26 September 2024