Malnutrition is common and costly, yet remains under-recognised and under-treated⁽Reference Elia and Russell¹⁾. Previous studies have shown that the ‘Malnutrition Universal Screening Tool’ (‘MUST’)⁽Reference Elia²⁾ predicts clinical outcome in hospitalised elderly⁽Reference Stratton³⁾; however, the clinical consequences of malnutrition in outpatients has not been investigated.

One hundred and ninety four outpatients (age 54 (sd 17.19) years; 45% female) were screened for malnutrition using ‘MUST’ at Southampton General Hospital between July 2008 and June 2009. Healthcare use was collected prospectively during the subsequent 6 months (hospital admissions (planned and emergency), length of hospital stay and outpatient appointments). The patients attended a range of outpatient clinics (40% gastroenterology, 21% surgical, 17% medical, 8% oncology and 14% other). Eighteen percent were at risk of malnutrition (12% medium and 6% high risk). Age and sex were not significantly related to malnutrition risk.

Outpatients at risk of malnutrition experienced significantly more hospital admissions (planned and emergency) and had a significantly longer length of hospital stay (table). The use of healthcare resources progressively increased from low to medium and high risk of malnutrition (table).

Med=medium risk; #=statistically significant ANOVA. Length of stay mean±sd.

*=Statistically significant; Chi² test; †statistically significant (P(trend)=0.018).

The impact of malnutrition on admissions remained significant even when adjusted for age. Six month mortality was higher in at risk patients (5.7%) compared to low risk (2.5%) although this was not significant (P=0.322, Chi²).

This study shows that malnutrition in general outpatients is associated with increased health care use. Identifying and appropriately treating malnutrition could potentially reduce health care costs.