Tesfaye Behailu Terefe, Yizengaw Mengist Awoke, Birhanu Tesema Etefa, Bosho Dula Dessalegn
Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
Human Anatomy Unit, Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
Front Nutr. 2024 Jan 8;10:1227840. doi: 10.3389/fnut.2023.1227840. eCollection 2023.
Malnutrition is a common geriatric syndrome affecting approximately half of the older population with a more pronounced occurrence rate in those hospitalized. It affects the physiology, and results in poor humanistic and clinical outcomes. In Africa, particularly in Ethiopia, albeit multiple studies are available on malnutrition in non-hospitalized older population, similar studies in inpatient settings are scarce. Therefore, this study was conducted with the intention to quantify the prevalence of malnutrition in older patients on inpatient admission and determine its associated factors.
A total of 157 older inpatients aged 60 years and above were included in the present study. The data collection format was developed after an in-depth review of relevant literatures. The full Mini-Nutritional Assessment (MNA) tool was employed to assess the nutritional status on admission. Data completeness was checked thoroughly. Descriptive statistics and logistic regression analysis were conducted using STATA 15.0. The area under the receiver operating characteristic curve (ROC), Hosmer-Lemeshow test, and classification table were computed to evaluate the final model goodness-of-fit.
Of the total study subjects, 81% were malnourished (MNA score <17) and 17% were at risk for malnutrition (MNA score of 17.5-23.5). However, upon review of the patients' medical charts, malnutrition diagnosis was recorded in only two patients. Rural residence (AOR = 2.823, 95%CI: 1.088, 7.324), self-reported financial dependence for expenses (AOR = 4.733, 95%CI: 1.011, 22.162), and partial dependence in functional autonomy on admission (AOR = 3.689, 95%CI: 1.190, 11.433) significantly increased the risk of malnutrition. The area under the ROC curve (0.754) and the Hosmer-Lemeshow test ( = 0.7564) indicated that the final model reasonably fits the data. The model`s sensitivity is 96.85%.
In the present study, an alarmingly high prevalence of malnutrition was identified older inpatients. The problem went undiagnosed in a similar percentage of patients. Several available literatures indicate the presence of an association between nutritional status and patient outcomes, thus strict nutritional screening at inpatient admission and intervention are recommended with special emphasis for those from rural areas, with financial dependence, and with functional impairment on admission.
营养不良是一种常见的老年综合征,影响着约一半的老年人群,在住院患者中发生率更高。它影响生理功能,并导致不良的人文和临床结局。在非洲,尤其是埃塞俄比亚,尽管有多项关于非住院老年人群营养不良的研究,但住院患者中的类似研究却很少。因此,本研究旨在量化老年住院患者入院时营养不良的患病率,并确定其相关因素。
本研究共纳入157名60岁及以上的老年住院患者。在深入回顾相关文献后制定了数据收集格式。采用完整的简易营养评估(MNA)工具评估入院时的营养状况。对数据完整性进行了全面检查。使用STATA 15.0进行描述性统计和逻辑回归分析。计算受试者工作特征曲线(ROC)下面积、Hosmer-Lemeshow检验和分类表以评估最终模型的拟合优度。
在所有研究对象中,81%营养不良(MNA评分<17),17%存在营养不良风险(MNA评分为17.5 - 23.5)。然而,在查阅患者病历后,仅两名患者记录了营养不良诊断。农村居住(比值比[OR]=2.823,95%置信区间[CI]:1.088,7.324)、自述费用上的经济依赖(OR = 4.733,95%CI:1.011,22.162)以及入院时功能自主性部分依赖(OR = 3.689,95%CI:1.190,11.433)显著增加了营养不良风险。ROC曲线下面积(0.754)和Hosmer-Lemeshow检验(P = 0.7564)表明最终模型合理拟合数据。该模型的敏感性为96.85%。
在本研究中,老年住院患者中营养不良的患病率高得惊人。类似比例的患者未被诊断出该问题。多项现有文献表明营养状况与患者结局之间存在关联,因此建议在住院入院时进行严格的营养筛查和干预,特别强调针对来自农村地区、有经济依赖以及入院时有功能障碍的患者。