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[Prognostic factors for mortality related to nutritional status in the hospitalized elderly].

Abstract：

BACKGROUND AND OBJECTIVE:The proportion of elderly patients hospitalized in acute care wards has progressively increased. Patients with a decreased functional status are prone to have malnutrition which negatively affects their prognosis and increases mortality. However, it is unclear whether functional and nutritional status are independent risk factors of mortality. PATIENTS AND METHOD:We investigated the relation between functional status (Katz index) and nutritional parameters and the incidence of mortality in a prospective, observational study of a cohort of elderly patients who were admitted to an internal medicine ward. Prevalence of malnutrition upon admission and cumulative incidence rate of in-hospital mortality were computed. Also, potential nutritional and functional prognostic factors for in-hospital mortality were identified by multiple logistic regression. RESULTS:The prevalence of malnutrition in 105 patients included in the cohort was 57.1% (95 percent confidence interval, 47.1% to 66.8%). The incidence of in-hospital mortality was 14.3% (95 percent confidence interval, 8.2% to 22.5%). After adjustment, independent prognostic factors for in-hospital mortality were: a high level of functional dependence (F and G categories of Katz index, OR 6.1; 95 percent confidence interval, 1.4 to 26.3), diminished levels of serum transferrin (each decrement of 1g/L, OR 8.3; 95 percent confidence interval, 3.4 to 20.0) and lymphocyte cell counts (each decrement of 0.5 x 10(9) cells/L, OR 2.3; 95 percent confidence interval, 1.5 to 3.5). CONCLUSIONS:The prevalence of malnutrition and the incidence of mortality are very high in the hospitalized elderly. In our cohort, decreased serum transferrin and lymphocyte cell count, and an increased level of functional status were associated with an increased risk of in-hospital mortality. Given the high prevalence of geriatric patients in acute care hospitals, strategies to promote an adequate nutrition may reduce the risk of death.

journal_name

Med Clin (Barc)

journal_title

Medicina clinica

authors

Asensio A,Ramos A,Núñez S

doi

10.1016/s0025-7753(04)74521-2

keywords:

subject

Has Abstract

pub_date

2004-09-25 00:00:00

pages

370-3

issue

10

eissn

0025-7753

issn

1578-8989

pii

S0025-7753(04)74521-2

journal_volume

123

pub_type

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