{
  "abstract": "Background: Hospital malnutrition is associated with adverse clinical outcomes, yet real-world evidence distinguishing nutritional risk screening from diagnostic assessment remains limited. This study evaluated a stepwise NRS2002-based screening and assessment pathway and examined associations between pathway-defined malnutrition and clinical outcomes in hospitalized patients.\n\nMethods: This retrospective cohort study was conducted at Xishan People’s Hospital from January 2022 to June 2025. Adult patients admitted for > = 24 h who completed Nutritional Risk Screening 2002 (NRS2002) within 48 h were included. NRS2002 was the universal screening tool. Patients with NRS2002 > = 3 underwent diagnostic assessment according to a predefined decision tree: oncology patients received Patient-Generated Subjective Global Assessment (PG-SGA), non-oncology patients with BMI < 18.5 kg/m2 received Global Leadership Initiative on Malnutrition (GLIM) evaluation, and remaining at-risk patients received Subjective Global Assessment (SGA). Primary outcomes included hospital-acquired infection (HAI), 30-day readmission among discharged-alive patients, and in-hospital mortality.\n\nResults: Among 2,856 patients (mean age 59.23 +/- 15.47 years; 52.17% male), 1,187 (41.56%) were identified as at nutritional risk by NRS2002. Three pathway groups were identified: NRS2002 < 3 (n = 1,669), NRS2002 > = 3 but not malnourished (n = 335), and malnourished (n = 852). The pathway-defined malnutrition proportion was 29.83% in the total cohort and 71.78% among NRS-positive patients. Malnourished patients had higher rates of HAI (14.67% vs. 5.29%; P < 0.001), 30-day readmission among discharged-alive patients (20.84% vs. 11.18%; P < 0.001), and in-hospital mortality (8.22% vs. 2.30%; P < 0.001). In multivariable models, malnutrition was associated with HAI (aOR = 2.19; 95% CI: 1.57–3.07), 30-day readmission among discharged-alive patients (aOR = 1.81; 95% CI: 1.38–2.37), and in-hospital mortality (aOR = 2.54; 95% CI: 1.59–4.04).\n\nConclusions: In this single-center retrospective cohort, malnutrition identified through a stepwise NRS2002-based assessment pathway was common and was associated with higher HAI, readmission, mortality, and length of stay. HIS-integrated nutrition software may support standardized documentation and workflow efficiency, but the present observational study did not directly evaluate software effectiveness or interventional care pathways.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Nutrition, Xishan People’s Hospital, Wuxi, 214105 Jiangsu China",
    "Emergency Intensive Care Unit, Suzhou Municipal Hospital (The Affiliated Suzhou Hospital of Nanjing Medical University), Suzhou, 215000 China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Qunfang Hua"
    },
    {
      "affs": [
        1
      ],
      "name": "Yang Yu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yun Feng"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/92981xezf2y5p.bib",
  "cited_by": 0,
  "doi": "10.1186/s41043-026-01366-y",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13737643/",
  "id": "92981xezf2y5p",
  "issns": [
    "1606-0997",
    "2072-1315"
  ],
  "landing_url": "https://doi.org/10.1186/s41043-026-01366-y",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2916|Clinical Nutrition and Gastroenterology"
    ]
  ],
  "openalex": "W7172018877",
  "pdf_url": null,
  "pmcid": "PMC13737643",
  "pmid": "42983858",
  "published": "2026-08-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/92981xezf2y5p.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:22:47Z",
      "native_id": "PMC13737643",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s41043-026-01366-y"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Prevalence and clinical outcomes of malnutrition in hospitalized patients: a real-world study using a stepwise screening-assessment pathway",
  "title_text": "Prevalence and clinical outcomes of malnutrition in hospitalized patients: a real-world study using a stepwise screening-assessment pathway",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:22:47Z",
  "url": "https://research.draconitic.com/paper/92981xezf2y5p",
  "venue": "Journal of Health, Population, and Nutrition",
  "versions": []
}