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. 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 = 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). 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.
Hua et al. (Sat,) studied this question.