Mukundan Megha, Kashyap Kritartha, Dhar Minakshi, Muralidharan Aishwarya, Agarwal Disha, Saxena Yogesh
Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Public Health, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Cureus. 2022 Feb 24;14(2):e22576. doi: 10.7759/cureus.22576. eCollection 2022 Feb.
Context Elderly people are at a high risk of malnutrition leading to poor outcomes and quality of life. Aims We aimed to find an association between the nutritional and functional status of hospitalized elderly patients and the three-month all-cause mortality among them. Settings and design A cross-sectional study was carried out at a tertiary care hospital in North India from July 2018 to December 2019. Methods and material A total of 177 patients were recruited for the study, and their demographic and clinical data were collected on a preformed questionnaire. Comorbidity, nutritional status, functional status, and depression were calculated using the Charlson Comorbidity Index (CCI), Mini Nutritional Assessment (MNA) form, Katz Index of Independence in Activities of Daily Living (Katz ADL), and Geriatric Depression Scale (GDS), respectively. Statistical analysis A Chi-square test was used to find the association between different qualitative variables. A regression model was used to find out the odds for mortality. Statistical significance was set at p<0.05. Results According to the MNA score, 49.7% (88) were at risk of malnutrition, and 22.6%(40) were malnourished. Malnutrition, Charlson Comorbidity Index, and the functional status of the patients were found to be associated with three-month mortality, with a p value of 0.005, 0.017, and 0.021, respectively. On regression analysis, malnutrition (odds ratio (OR): 3.796; 95% confidence interval (CI): 1.178-12.234; p=0.025) and the functional status (OR: 3.160; 95% CI: 1.256-7.952; p=0.015) of the study participants were found to have higher odds for three-month all-cause mortality. Conclusions Nutritional status and ADL assessed at the time of discharge are good prognostic markers of health outcomes in the elderly population. Key message ADL and nutritional assessment at admission and discharge should be routinely incorporated in the geriatric assessment of hospitalized patients to triage and prognosticate.
老年人营养不良风险高，会导致不良后果和生活质量下降。目的：我们旨在找出住院老年患者的营养和功能状况与他们三个月内全因死亡率之间的关联。设置与设计：2018年7月至2019年12月在印度北部一家三级护理医院开展了一项横断面研究。方法与材料：共招募177名患者参与研究，通过预先设计的问卷收集他们的人口统计学和临床数据。分别使用Charlson合并症指数（CCI）、微型营养评定法（MNA）表格、日常生活活动能力Katz指数（Katz ADL）和老年抑郁量表（GDS）计算合并症、营养状况、功能状况和抑郁情况。统计分析：采用卡方检验找出不同定性变量之间的关联。使用回归模型找出死亡几率。设定统计学显著性为p<0.05。结果：根据MNA评分，49.7%（88名）存在营养不良风险，22.6%（40名）营养不良。发现营养不良、Charlson合并症指数和患者的功能状况与三个月死亡率相关，p值分别为0.005、0.017和0.021。回归分析显示研究参与者的营养不良（比值比（OR）：3.796；95%置信区间（CI）：1.178 - 12.234；p = 0.025）和功能状况（OR：3.160；95% CI：1.256 - 7.952；p = 0.015）三个月全因死亡率几率更高。结论：出院时评估的营养状况和日常生活活动能力是老年人群健康结局的良好预后指标。关键信息：入院和出院时的日常生活活动能力及营养评估应常规纳入住院患者的老年评估中，以进行分类和预后判断。
