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Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up

Journal Article


Abstract


  • Background/Objectives: Older malnourished patients experience increased surgical complications and greater morbidity compared with their well-nourished counterparts. This study aimed to assess whether nutritional status at hospital admission predicted clinical outcomes at 18 months follow-up.

    Subjects/Methods: A retrospective analysis of N=2076 patient admissions (65+ years) from two subacute hospitals, New South Wales, Australia. Analysis of outcomes at 18 months, according to nutritional status at index admission, was performed in a subsample of n=476. Nutritional status was determined within 72 h of admission using the Mini Nutritional Assessment (MNA). Outcomes, obtained from electronic patient records, included hospital readmission rate, total Length of Stay (LOS), change in level of care at discharge and mortality. Survival analysis, using a Cox proportional hazards model, included age, sex, Major Disease Classification, mobility and LOS at index admission as covariates.

    Results: At baseline, 30% of patients were malnourished and 53% were at risk of malnutrition. LOS was higher in malnourished and at risk, compared with well-nourished patients (median (interquartile range): 34 (21, 58); 26 (15, 41); 20 (14, 26) days, respectively; P<0.001). Hazard rate for death in the malnourished group is 3.41 (95% confidence interval: 1.07–10.87; P=0.038) times the well-nourished group. Discharge to a higher level of residential care was 33.1%, 16.9% and 4.9% for malnourished, at-risk and well-nourished patients, respectively; P0.001).

    Conclusion: Malnutrition in elderly subacute patients predicts adverse clinical outcomes and identifies a need to target this population for nutritional intervention following hospital discharge.

Publication Date


  • 2012

Citation


  • Charlton, K., Nichols, C., Bowden, S., Milosavljevic, M., Lambert, K., Barone, L., Mason, M. & Batterham, M. (2012). Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up. European Journal of Clinical Nutrition, 66 (11), 1224-1228.

Scopus Eid


  • 2-s2.0-84868664943

Ro Metadata Url


  • http://ro.uow.edu.au/hbspapers/3242

Has Global Citation Frequency


Number Of Pages


  • 4

Start Page


  • 1224

End Page


  • 1228

Volume


  • 66

Issue


  • 11

Place Of Publication


  • United Kingdom

Abstract


  • Background/Objectives: Older malnourished patients experience increased surgical complications and greater morbidity compared with their well-nourished counterparts. This study aimed to assess whether nutritional status at hospital admission predicted clinical outcomes at 18 months follow-up.

    Subjects/Methods: A retrospective analysis of N=2076 patient admissions (65+ years) from two subacute hospitals, New South Wales, Australia. Analysis of outcomes at 18 months, according to nutritional status at index admission, was performed in a subsample of n=476. Nutritional status was determined within 72 h of admission using the Mini Nutritional Assessment (MNA). Outcomes, obtained from electronic patient records, included hospital readmission rate, total Length of Stay (LOS), change in level of care at discharge and mortality. Survival analysis, using a Cox proportional hazards model, included age, sex, Major Disease Classification, mobility and LOS at index admission as covariates.

    Results: At baseline, 30% of patients were malnourished and 53% were at risk of malnutrition. LOS was higher in malnourished and at risk, compared with well-nourished patients (median (interquartile range): 34 (21, 58); 26 (15, 41); 20 (14, 26) days, respectively; P<0.001). Hazard rate for death in the malnourished group is 3.41 (95% confidence interval: 1.07–10.87; P=0.038) times the well-nourished group. Discharge to a higher level of residential care was 33.1%, 16.9% and 4.9% for malnourished, at-risk and well-nourished patients, respectively; P0.001).

    Conclusion: Malnutrition in elderly subacute patients predicts adverse clinical outcomes and identifies a need to target this population for nutritional intervention following hospital discharge.

Publication Date


  • 2012

Citation


  • Charlton, K., Nichols, C., Bowden, S., Milosavljevic, M., Lambert, K., Barone, L., Mason, M. & Batterham, M. (2012). Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up. European Journal of Clinical Nutrition, 66 (11), 1224-1228.

Scopus Eid


  • 2-s2.0-84868664943

Ro Metadata Url


  • http://ro.uow.edu.au/hbspapers/3242

Has Global Citation Frequency


Number Of Pages


  • 4

Start Page


  • 1224

End Page


  • 1228

Volume


  • 66

Issue


  • 11

Place Of Publication


  • United Kingdom