The prognostic value of combining MNA-SF nutritional status and probable sarcopenia for 90-day readmission in elderly inpatients with multimorbidity.

OBJECTIVE: To explore the predictive value of nutritional status combined with Probable sarcopenia assessment for all-cause readmission of elderly inpatients with multimorbidity within 90 days after discharge. METHODS: In this single-centre retrospective cohort study, a total of 244 patients aged ≥65 years admitted to our hospital from January 2023 to March 2025 were selected as the research subjects. Abnormal nutritional status (malnutrition or risk of malnutrition, MNA-SF ≤11) and probable sarcopenia (per modified EWGSOP2-based criteria) were assessed within 48 h of admission, and patients were divided into a readmission group (59 cases) and a non-readmission group (185 cases) according to whether they were readmitted within 90 days after discharge. RESULTS: The age of patients in the readmission group was significantly higher than that in the non-readmission group (P < 0.05), the Charlson Comorbidity Index was higher (P < 0.05), the level of C-reactive protein was higher (P < 0.05), and the serum albumin, handgrip strength and calf circumference were lower (P < 0.05). The overall prevalence of probable sarcopenia was 31.1%, and the prevalence of malnutrition (including risk) was 73.8%. Abnormal nutritional status was defined as MNA-SF ≤11 (combining at-risk and malnourished categories). The combined group analysis showed that the 90-day readmission rate of patients with abnormal nutritional status and probable sarcopenia (Group D) was the highest, reaching 47.8%, which was significantly higher than that of other groups (P < 0.05). Multivariate logistic regression analysis showed that after adjusting for age, sex, comorbidities and inflammatory markers, the combined status was independently associated with higher odds of 90-day readmission (aOR=3.94, 95%CI: 1.73-8.96, P = 0.001). The combined assessment model demonstrated moderate discriminative ability (AUC 0.724, 95% CI: 0.651-0.797), which was statistically significantly better than that of nutrition or probable sarcopenia assessment alone (DeLong P < 0.05). CONCLUSION: In this single-center retrospective cohort, the coexistence of abnormal nutritional status (MNA-SF ≤11) and probable sarcopenia was independently associated with higher odds of 90-day readmission in elderly hospitalized patients with multimorbidity. Larger prospective multicenter studies are needed to validate the combined assessment and determine whether targeted interventions reduce readmission.