Risk factors for malnutrition in patients with diabetic foot ulcer and its association with prolonged length of hospitalization

Purpose: To investigate the occurrence and risk factors of malnutrition in hospitalized diabetic foot ulcer (DFU) patients using the Global Leadership Initiative on Malnutrition (GLIM) criteria and examine the association between malnutrition and hospital length of stay (LOS). Methods: Observational study of DFU inpatients at two campuses of a hospital from January 2021 to June 2023. Malnutrition was diagnosed per GLIM. LOS was recorded; >17 days defined prolonged LOS. Univariate and multivariate logistic regression identified risk factors for malnutrition and the association between malnutrition and prolonged LOS. Results: Among 219 DFU patients, 38.36% were malnourished (GLIM) and 42% (n=92) had prolonged LOS. Independent risk factors for malnutrition were lower BMI (P<0.001), lower albumin (P=0.002), higher HbA1c (P<0.001), ulcer infection (P<0.001), longer LOS (P=0.010), and lower ABI (P=0.024). Malnutrition was independently associated with prolonged LOS; malnourished patients had 2.857 times higher odds (95% CI 1.497–5.450; P=0.001) of prolonged LOS. Conclusion: Malnutrition is highly prevalent in DFU and is linked to approximately threefold higher odds of prolonged hospitalization. Implementing GLIM-based diagnosis in routine care is important given its predictive value.