Protein Intake at the First Day of Full‐Oral Intake During Hospitalization Is Associated With Complications and Hospital Length of Stay

BACKGROUND: Malnutrition at admission is associated with complication‐related readmission and prolonged hospital stay. This underscores the importance of an adequate intake ‐ more particular, protein intake ‐ to prevent further deterioration and treat malnutrition during hospitalization. Our objective was to assess whether protein intake relative to requirements at the first day of full oral intake is associated with complications and hospital length of stay (LOS) in medical and surgical patients. METHODS: This was a post hoc analysis of a prospective cohort study in patients on the wards of gastroenterology, orthopedics, urology, and gynecology. Protein intake was measured by subtracting the weight of each dish at the end of each mealtime from the weight at serving time. Complications and LOS were reported using patients’ medical records. RESULTS: In total, complications were observed in 92 of 637 (14.4%) patients, with a median LOS of 5 days (3.0–7.0). An absolute increase of 10% protein intake relative to requirements reduced the relative complication risk by 10% (odds ratio, 0.900; 95% CI, 0.83–0.97; P < .05). Also, LOS was shortened by 0.23 days for each increase of 10% in protein intake relative to requirements (95% CI, –0.3 to –0.2; P < .05). CONCLUSION: Protein intake relative to requirements at the first day of full‐oral intake is associated with the risk of complications and hospital LOS. This analysis bolsters the evidence for the importance of any hospital meal service that increases protein intake.