1. www.postersession.com Malnutrition is common in US hospitalized patients In 2010, approximately 1.2 million hospitalized patients over the age of 18 had a diagnosis of malnutrition (dx) in the US. Older adults are at increased risk for malnutrition than younger adults However, differences in the characteristics and comorbidities in those younger and older adults with a diagnosis of malnutrition are not known. Methods A Comparison of Characteristics by Age of Hospitalized Adults with a Diagnosis of Malnutrition: United States, 2010 Among patients with a dxmal, those ≥ 65 were 1.5 times more common than those < than 65. Older dxmal patients were more likely to have chronic comorbidities than their younger counterparts. Among older patients with dxmal, length of stay and cost of care were lower More older dxmal patients died during their hospital stay. Older dxmal patients were three-times more likely to be admitted to the hospital from a skilled nursing facility and twice as likely to be discharged to an intermediate or skilled care facility. Among patients with a dxmal who received parenteral nutrition, 9.9% were < 65 and 7.2% were ≥ 65. Among patients with a dxmal who received enteral nutrition, 4.9% were < 65 and 5.2% were ≥ 65. Data is from the 2010 Healthcare Cost and Utilization Project (HCUP), which contain patient-level data with ICD-9CM diagnosis codes on hospital inpatient stays. 1 Data was weighted to generate nationally representative estimates of U.S. hospitalizations. Characteristics of older adults and younger adults with a dxmal during their hospital stay were identified and compared. Older hospitalized adults with a dxmal appear to be more frail and have greater comorbidities than their younger counterparts. Yet their length of stay and cost of care is lower, and their mortality is higher. It may be beneficial to carefully monitor the nutritional status in hospitalized older adults with dxmal, especially those admitted from skilled nursing facilities. Background Contact: rad83@drexel.edu Results Conclusions Purpose To examine differences in demographic characteristics and comorbidities in a nationally representative sample of older ( ≥65 years ) and younger (18-64 years) hospitalized patients with a diagnosis of malnutrition (dxmal). R.A. DiMaria-Ghalili 1, J. Slaughter 1, E. Gonzalez 1, P. Abeysekara 2, H. Resnick 3, P. Guenter 3 1-College of Nursing & Health Professions, Drexel University, Philadelphia PA; 2-School of Public Health, Drexel University, Philadelphia PA; 3-American Society for Parenteral & Enteral Nutrition, Silver Spring MD Table I. Malnourished Adult Inpatients by Age Descriptive Characteristics Table 3. Comorbid Conditions of Malnourished Adult Patients, United States, 2010 Age 18-64 yrsAge >65 yrs CharacteristicEstimate 95% CI Weighted N467,378 727,858 Mean Age49.9 (CI 49.6-50.3)78.9 (CI 78.7-79.9) Female (%)48.8 (CI 48.1-48.6)55.9 (CI 55.4-56.4) Race/ethnicity (%) White Black Hispanic API Native American Other 65.5 (CI 62.7-68.2) 21.3 (CI 18.9-23.6) 7.9 (CI 6.5-9.3) 1.7 (CI 1.4-2.1) 0.8 (CI 0.5-1.0) 2.9 (CI 2.1-3.7) 74.1 (CI 71.8-76.4) 14.3 (CI 12.5-16.1) 5.9 (CI 4.7-7.1) 2.5 (CI 1.8-3.2) 0.5 (CI 0.3-0.7) 2.7 (CI 1.8-3.5) Expected Primary Payer (%) Medicare Medicaid Private, including HMO Self-pay No Charge Other 28.7 (CI 27.8-29.7) 23.9 (CI 22.7-25.2) 35.0 (CI 33.3-36.6) 7.5 (CI 6.7-8.4) 0.7 (CI 0.4-1.0) 4.1 (CI 3.4-4.8) 89.1 (CI 87.6-90.6) 2.1 (CI 1.4-2.7) 7.4 (CI 6.4-8.3) 0.5 (CI 0.2-0.8) 0.1 (CI 0.0-0.1) 0.9 (CI 0.7-1.1) Table 2. Admission and Discharge Characteristics for Malnourished Adult Patients Age 18-64 yrsAge >65 yrs Characteristic Estimate 95% CI Weighted N 467,378727,858 Length of Stay (mean days) 13.7 (CI 13.1-14.3)11.6 (CI 11.1-12.0) Total Costs (mean $) 106,535 (CI 96,780- 116,290) 80,191 (CI 74,637- 85,745) Admission Type (%) Emergency Urgent Elective Trauma Center Other 59.6 (CI 56.5-62.7) 20.7 (CI 17.8-23.5) 18.4 (CI 16.0-20.7) 1.4 (CI 0.8-1.9) 0.0 (CI 0.0-0.0) 63.2(CI 60.2-66.1) 18.9 (CI 16.5-21.3) 17.3 (CI 15.1-19.5) 0.6 (CI 0.4-0.8) 0.0 (CI 0.0-0.0) Point of Origin Non-health care facility Clinic Transfer from: Hospital Skilled nursing facility Another healthcare facility Emergency Room Court/law enforcement Transfer from another Home Health Agency Readmission to Same Home Health Agency Transfer from one distinct unit of the hospital to another 46.9 (CI 44.0-49.7) 5.8 (CI 4.2-7.3) 11.2 (CI 9.3-13.1) 2.0 (CI 1.6-2.4) 1.6 (CI 0.9-2.3) 31.6 (29.1-34.0) 0.1 (CI 0.1-0.2) <0.01 0.8 (CI 0.6-1.0) 44.0 (CI 41.7-46-3) 4.0 (CI 3.3-4.7) 10.2 (CI 8.1-12.3) 6.4 (CI 5.3-7.6) 1.7 (CI 1.2-2.1) 32.3 (CI 30.2-34.4) 0.02 (CI 0.01-0.03) <0.01 1.3 (CI 1.0-1.7) Discharge Disposition (%) Routine Transfer to short-term hospital Other transfers Home Health Care Against Medical Advice Died Discharged alive, destination unknown 42.1 (CI 40.8-43.4) 4.1 (CI 3.7-4.5) 25.0 (CI 24.1-25.9) 20.7 (CI 19.6-21.8) 1.3 (CI 1.2-1.5) 6.6 (CI 6.3-6.9) 0.2 (CI 0.0-0.3) 16.9 (CI 16.0-17.7) 3.1 (CI 2.8-3.4) 49.2 (CI 48.3-50.1) 19.6 (CI 18.9-20.3) 0.2 (CI 0.2-0.2) 10.7 (CI 10.3-11.1) 0.3 (0.1-0.6) Age 18-64 yrsAge >65 yrs Comorbid Condition (%)Estimate 95% CI Congestive heart failure Valvular disease Pulmonary circulation disorders Peripheral vascular disorders AIDS Alcohol abuse Deficiency anemias Rheumatoid arthritis Chronic blood loss anemia Chronic pulmonary disease Coagulopathy Depression Diabetes Diabetes with chronic complications Drug abuse Hypertension Hypothyroidism Liver disease Lymphoma Fluid and electrolyte disorders Metastatic cancer Other neurological disorders Obesity Paralysis Psychoses Renal failure Solid tumor without metastasis Peptic ulcer disease Weight loss 8.6 (CI 8.2-9.1) 2.4 (CI 2.2-2.6) 3.6 (CI 3.4-3.9) 5.2 (CI 4.8-5.5) 1.1 (CI 0.9-1.3) 12.8 (CI 12.1-13.4) 35.9 (CI 34.2-37.5) 3.1 (CI 2.9-3.2) 2.4 (CI 2.2-2.6) 19.7 (CI 18.8-20.6) 14.1 (CI 13.2-15.1) 14.3 (CI 13.6-15.0) 15.4 (CI 14.7-16.2) 6.5 (CI 6.1-6.9) 7.0 (CI 6.4-7.7) 37.2 (CI 35.8-38.5) 8.0 (CI 7.6-8.5) 9.5 (CI 8.9-10.2) 1.2 (CI 1.1-1.3) 53.1 (CI 51.6-54.6) 7.3 (6.7-7.9) 10.4 (CI 9.9-10.8) 8.7 (CI 8.0-9.5) 7.4 (CI 6.9-7.8) 7.8 (CI 7.4-8.3) 14.2 (CI 13.5-14.9) 3.9 (CI 3.7-4.2) 0.1 (CI 0.1-0.1) 93.9 (CI 93.5-94.3) 22.5 (CI 21.8-23.2) 6.4 (CI 5.9-6.8) 5.0 (CI 4.7-5.4) 10.6 (CI 10.0-11.2) 0.1 (CI 0.04-0.1) 3.0 (CI 2.8-3.2) 36.8 (CI 35.3-38.4) 3.5 (CI 3.3-3.7) 2.3 (CI 2.1-2.4) 27.2 (CI 26.4-28.0) 10.2 (CI 9.6-10.9) 11.1 (CI 10.5-11.6) 19.7 (CI 19.0-20.5) 5.7 (CI 5.3-6.1) 0.5 (CI 0.5-0.6) 57.0 (CI 55.6-58.4) 15.0 (CI 14.4-15.6) 2.7 (CI 2.6-2.9) 1.8 (CI 1.7-1.9) 54.2 (CI 52.9-55.4) 6.5 (CI 6.2-6.7) 14.7 (CI 14.1-15.2) 4.8 (CI 4.4-5.2) 5.4 (CI 5.1-5.7) 4.4 (CI 4.1-4.7) 22.3 (CI 21.5-23.1) 5.1 (CI 4.9-5.3) 0.1 (CI 0.1-0.1) 95.3 (CI 95.0-95.5 1 Corkins M, et al (2014). Malnutrition Diagnoses in Hospitalized Patients: United States, 2010. Journal of Parenteral and Enteral Nutrition, 38 (2) 186-95. Reference