Background: Malnutrition, defined as deficiencies or excesses in nutrient intake, is associated with worse short and long-term outcomes compared to similar people without the diagnosis. The ASPEN or GLIM criteria are used to diagnose malnutrition, but these criteria are somewhat vague and measurement standards are typically not objective. The Inpatient Prospective Payment System considers severe [...]

Background: Growth faltering or failure to thrive is a common cause of admission in infancy and early childhood. In the United States, approximately 2-10% of children experience lower-than-expected growth associated with malnutrition (Tang et al). Growth faltering accounts for 3-5% of pediatric hospitalizations (Mazze et al, 2019). Malnutrition is associated with complications of increased risk [...]

Background: Malnutrition affects up to 30% of inpatients, but is rarely diagnosed. This leads to under-treatment and poor patient outcomes including: infections, pressure ulcers, and poor wound healing. In the MS-DRG system, malnutrition is considered either a major complication/comorbidity (MCC) or a complication/comorbidity (CC), depending on specificity and severity. Therefore, missed diagnoses significantly impact patient [...]

Background: Many hospitalized adults arrive with pre-existing malnutrition, which is associated with high risk of adverse outcomes. As such, malnutrition is a common variable in cost and quality risk adjustment models based on hospital discharge diagnosis codes. Hospital dietitians assess patients for malnutrition and generally document the details of their evaluations. However, coding professionals cannot [...]

Background: Anywhere from 20-50% of all hospitalized adult patients are impacted by malnourishment on admission. Although malnutrition has a worldwide impact on patient outcomes, it is frequently under documented. This proves detrimental to patient outcomes as the average length of stay is 1.5 times greater than those not affected by malnutrition. This is further exemplified [...]

Background: According to a report of the Healthcare Cost and Utilization Project (HCUP) that looked at hospital admissions in 2013, the care of hospitalized malnourished patients costs twice as much as those without malnourishment due to prolonged hospital stays and increased readmission rates. Furthermore, up to 30 to 50 percent of patients are malnourished upon [...]

Background: Malnutrition is a significant indicator for illness severity and expected mortality. Prior to any process improvement interventions in 2014, only 4.7% of UNMH inpatients were diagnosed with malnutrition at discharge, much lower than the published national inpatient prevalence of 20-50%. Given the relatively high level of poverty in NM, we believe these lower rates [...]

Case Presentation: A 58-year-old woman with self-reported history of mast cell activation syndrome and chronic back pain presented to the hospital three times over a two-month period for recurrent skin/soft tissue infections. Her first hospitalization (10/19 – 10/24) was for bilateral hand/wrist abscesses requiring extensive tenosynovectomy and radiocarpal arthrotomy; cultures grew MSSA and she was [...]

Case Presentation: We present a case of a 63-year-old male with a past medical history of hypertension and alcohol use disorder (multiple beers per day) who presented with a two-week history of black stools. On arrival, he was hypothermic, tachycardic, and hypotensive, likely due to hemorrhagic shock. Physical examination revealed melena and anasarca. Labs were [...]

Background: Most primates, including humans, belonging to the suborder Haplorrhine lack the innate ability to synthesize ascorbic acid (Vitamin C) and hence exclusively depend on dietary intake (generally plant-based diets) to prevent deficiency. Modern humans’ trend of consuming ultra-processed foods that lack crucial micronutrients places us at risk for developing micronutrient deficiencies. Currently, there is [...]