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Nutritional predictors of mortality after discharge in elderly patients on a medical ward
Author(s) -
Buscemi Silvio,
Batsis John A.,
Parrinello Gaspare,
Massenti Fatima M.,
Rosafio Giuseppe,
Sciascia Vittoria,
Costa Flavia,
Pollina Addario Sebastiano,
Mendola Serena,
Barile Anna M.,
Maniaci Vincenza,
Rini Nadia,
Caimi Gregorio
Publication year - 2016
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12637
Subject(s) - medicine , hazard ratio , confidence interval , proportional hazards model , anthropometry , malnutrition , prospective cohort study , risk of mortality , observational study , cohort study
Background Malnutrition in elderly inpatients hospitalized on medical wards is a significant public health concern. The aim of this study was to investigate nutritional markers as mortality predictors following discharge in hospitalized medical elderly patients. Materials and methods This is a prospective observational cohort study with follow‐up of 48 months. Two hundred and twenty‐five individuals aged 60 and older admitted from the hospital emergency room in the past 48 h were investigated at the medical ward in the University hospital in Palermo (Italy). Anthropometric and clinical measurements, Mini‐nutritional Assessment (MNA) questionnaire, bioelectrical (BIA) phase angle (PA), grip strength were obtained all within 48 h of admission. Mortality data were verified by means of mortality registry and analysed using Cox‐proportional hazard models. Results Ninety (40%) participants died at the end of follow‐up. There were significant relationships between PA, MNA score, age and gender on mortality. Patients in the lowest tertile of PA (< 4·6°) had higher mortality estimates [I vs II tertile: hazard ratio (HR) = 3·40; 95% confidence interval (CI): 2·01–5·77; II vs III tertile: HR = 3·83; 95% CI: 2·21–6·64; log‐rank test: χ 2 = 43·6; P < 0·001]. Similarly, the survival curves demonstrated low MNA scores (< 22) were associated with higher mortality estimates (HR = 1·85; 95% CI: 1·22–2·81 χ 2 = 8·2; P = 0·004). Conclusions The MNA and BIA‐derived phase angle are reasonable tools to identify malnourished patients at high mortality risk and may represent useful markers in intervention trials in this high‐risk subgroup.