Nutritional Predictors of Mortality after Discharge in Elderly Patients on a Medical Ward

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Citation

Buscemi, Silvio; Batsis, John A.; Parrinello, Gaspare; Massenti, Fatima M.; Rosafio, Giuseppe; Sciascia, Vittoria; Costa, Flavia; Pollina Addario, Sebastiano; Mendola, Serena; & Barile, Anna M., et al. (2016). Nutritional Predictors of Mortality after Discharge in Elderly Patients on a Medical Ward. European Journal of Clinical Investigation, 46(7), 609-618.

Abstract

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.

URL

https://doi.org/10.1111/eci.12637

Reference Type

Journal Article

Year Published

2016

Journal Title

European Journal of Clinical Investigation

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

Article Type

Regular

Continent/Country

Italy

ORCiD

Batsis - 0000-0002-0845-4416