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Protein‐Energy Malnutrition in Elderly Medical Patients
Author(s) -
Constans T.,
Bacq Y.,
Bréchot J.F.,
Guilmot J.L.,
Choutet P.,
Lamisse F.
Publication year - 1992
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1992.tb02080.x
Subject(s) - medicine , malnutrition , prospective cohort study , anthropometry , body mass index , circumference , pediatrics , mathematics , geometry
Study Objective To evaluate (1) the prevalence of protein‐energy malnutrition in elderly patients; (2) the changes in nutritional status during the hospital stay; and (3) (main objective) the relationship between simple nutritional parameters and short‐term in‐hospital mortality. Design Prospective time series at admission and on the 15th day of hospitalization. Setting Medical care unit in a teaching hospital. Participants Consecutive sample of 324 hospitalized patients ≥70 years (86.4% of eligible patients). Norms of measurements were obtained from a referred sample of healthy control subjects (26 males and 36 females). Main Outcome Measures Mid‐arm circumference, triceps skinfold thickness, serum albumin, prealbumin, and retinol‐binding protein levels were measured in patients at admission and on the 15th day. Results (1) Prevalence of PEM was 30% in male and 41% in female patients. (2) Both mid‐arm circumference and serum albumin level decreased over the first 15 days of hospital stay (53 patients, paired t test, P < 0.05). Triceps skinfold thickness did not change. (3) A step‐wise discriminant‐function analysis determined the utility of the parameters at admission as predictors of in‐hospital mortality before the 15th day. Mid‐arm circumference, triceps skinfold thickness, albumin, and prealbumin levels, as well as age, are predictors of in‐hospital mortality, with 73% sensitivity, 69% specificity, and 70% of correctly classified patients of both sexes. Conclusions Parameters used are predictors for short‐term in‐hospital mortality of elderly patients hospitalized in an acute medical unit. The lean body mass is preferentially mobilized for energy during hospitalization.