Impact of nutrition status on morbidity and mortality in a select population of geriatric rehabilitation patients

Article Abstract:

The relationship between protein-calorie undernutrition (PCU; insufficient protein and total calories in the diet) and illness and death in hospitalized patients is controversial. The markers for PCU have been found to include involuntary weight loss and low blood levels of protein, cholesterol, and hemoglobin. In previous studies, it was difficult to determine whether PCU directly caused illness and death, or it was simply linked to advanced age, debilitation, or severe underlying disease. The relationships among PCU and other factors influencing the medical outcome of 110 patients admitted to a geriatric rehabilitation unit were assessed. Following admission, complications developed in 39 percent of patients. Twenty-five percent of patients developed infection and 15 percent had a life-threatening complication. The average stay for patients with at least one complication was 43 days, compared with 21 days for patients without complications. Over half of the patients had debilitating diseases such as congestive heart failure, diabetes, stroke, Alzheimer's disease, and pulmonary or kidney diseases. The factors which best predicted development of complications were: the score for independence in activities of daily living (including dressing, bathing, toileting, eating, and so forth), blood levels of the protein albumin; weight loss during the previous year; and presence of kidney or lung disease. The relative importance of each of these factors varied for individual complications, such as infection and major complications, or for death, which was most strongly related to problems when admitted, body weight, and presence of lung disease. The study results indicate that nutritional factors do correlate with risk of complications, and are therefore important in a geriatric population. Further studies are needed to validate this preliminary research. (Consumer Summary produced by Reliance Medical Information, Inc.)

Nursing home patients

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Protein-energy undernutrition and the risk of mortality within 1 y of hospital discharge in a select population of geriatric rehabilitation patients

Article Abstract:

Protein-energy undernutrition has been associated with an increased risk of death in the hospital; patients who have had involuntary weight loss tend to have a poorer prognosis than those who have maintained their nutrition. One study showed that the levels of the blood protein, albumin, and the amount of weight lost within the year before hospital admission (both indicators of nutritional status) were correlated with the development of complications in patients in a hospital geriatric rehabilitation unit (GRU). Thus the extent of disease and death in the hospital could be lessened by improving the nutritional status of the patients. However, it was unclear whether nutrition was an important factor in affecting the outcome after hospital discharge. Hence, the relationship between nutritional status and risk of death was assessed in 109 patients when admitted to a GRU and for a one-year duration after hospital discharge. Thirty-three patients died during the study, including 11 before and 22 after discharge. Of 81 factors (nutrition and non-nutrition related) analyzed for ability to predict death during the year after discharge, the best predictor was the amount of weight lost in the year before admission, followed by the skinfold thickness beneath the shoulder blade (which indicates body fat stores), and a measure of patient function called the Katz Index of Activities of Daily Living score. These findings show that nutritional status is very influential in predicting death among frail geriatric patients, both in the hospital and after hospital discharge. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Nutrition disorders

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Protein - Energy Undernutrition Among Elderly Hospitalized Patients A Prospective Study

Article Abstract:

Many elderly hospital patients are not fed adequately, which appears to increase their risk of death. In a study of 497 elderly hospital patients, 102 had a food intake that was less than half of their estimated energy requirements. Many could not have anything by mouth and were not fed via a feeding tube or any other method. These patients were eight times more likely to die in the hospital and three times more likely to die within three months of their hospital admission.

Hospital patients, Aged patients, Elderly patients

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