Association of the Presence Anemia and Malnutrition in Hospitalized Patients With Exclusive Enteral Nutrition

Jesus, Sibila Reck de; Alves, Bruna Pessoa; Golin, Anieli; Schott, Mairin; Dachi, Leonardo; Marques, Antônio Luiz; Colpo, Elisângela

doi:10.20960/nh.1628

Cited by 5 publications

(7 citation statements)

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“…Anaemia has already been reported as having an important relationship with LSA through systemic inflammation in hospitalized patients. 28 LSA is a frequent feature of chronic kidney disease and depends on many factors, not only albuminuria and inflammation but also albumin homeostasis. Especially in patients with end‐stage renal disease, LSA is also the result of decreased synthesis and increased degradation of protein.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of follow‐up serum albumin after acute myocardial infarction

Yoshioka

Tanaka

Nishihira³

et al. 2021

ESC Heart Failure

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Aims Previous studies have suggested that low serum albumin (LSA) at admission for acute myocardial infarction (AMI) is associated with adverse in-hospital outcomes. The aim of this study was to investigate whether LSA in the remote phase after AMI is prognostic for long-term outcomes. Methods and resultsThis was a single-centre, retrospective study of consecutive patients admitted for AMI from 2008 to 2016. Serum albumin concentrations were measured serially at admission and 1 year after discharge in Japanese patients. Occurrence of a composite of hospitalization for heart failure and cardiovascular death was the primary endpoint. The prognostic impact of remote LSA, defined as a serum albumin level < 3.8 g/dL at 1 year after discharge, was investigated with a multivariate-adjusted Cox model. Among 1424 subjects analysed, 289 (20.3%) had LSA at admission, and 165 (11.6%) had LSA at 1 year after discharge. During follow-up (median: 4.1 years), the primary endpoint occurred in 31/165 (18.8%) patients with remote LSA and 42/1259 (3.3%) patients without it [adjusted hazard ratio (aHR), 2.76; 95% confidence interval (CI), 1.32 to 5.72; P = 0.007]. The all-cause death rate was 29.7% (49/165) in patients with remote LSA and 4.3% (54/1259) in patients without it (aHR, 4.02; 95% CI, 2.36 to 6.87; P < 0.001). The prognostic impact of remote LSA was consistent across albumin status in the acute phase of AMI. Conclusions Regardless of albumin status in the acute phase of AMI, LSA in the remote phase after AMI was significantly associated with long-term adverse outcomes.

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Section: Discussionmentioning

confidence: 99%

Prognostic impact of follow‐up serum albumin after acute myocardial infarction

Yoshioka

Tanaka

Nishihira³

et al. 2021

ESC Heart Failure

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“…The finding that anemia was associated with decreased risk of fasciotomy may be explained by that anemia could be interpreted as a proxy for poor general health (8,9) and aging (10), as such, also lower muscle mass.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Fasciotomy After Revascularization for Acute Lower Limb Ischaemia

2021

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Background: Acute lower limb ischaemia (ALI) is a life and limb threatening vascular emergency. Acute compartment syndrome (ACS) may develop upon revascularization. The risk of fasciotomy was hypothesized to be decreased in women due to their lower calf muscle mass. The main aim was to evaluate risk factors for fasciotomy after revascularization for ALI.Methods: This is a retrospective observational study of patients undergoing revascularization for ALI between 2001 and 2018. Factors associated with outcome at 1 year in univariable analysis (p < 0.1) were chosen for multi-variable analysis and expressed in Odds Ratios (OR) with 95% confidence intervals (CI).Results: The median age for women (n = 394) was 75 years and men (n = 449) was 70 years (p < 0.001). The frequency of fasciotomy was 10.0% (84/843). The median in-hospital stay was 28 vs. 6 days for patients undergoing fasciotomy and not, respectively (p < 0.001). In adjusted analysis, renal insufficiency (OR 1.77, 95% CI 1.04–3.01), motor deficit (OR 4.40, 95% CI 2.45–7.92), popliteal artery aneurysm thromboembolism (OR 2.26, 95% CI 1.06–4.80), and open vascular surgery (OR 3.43, 95% CI 1.97–5.98) were associated with an increased risk of fasciotomy. Female patients (OR 0.49, 95% CI 0.28–0.84) and anemia (OR 0.52, 95% CI 0.28–0.84) had a lower risk. The major amputation/mortality rate at 1-year was 27.7%; fasciotomy (OR 1.94, 95% CI 1.11–3.40), anemia (OR 1.84, 95% CI 1.24–2.73) and female gender (OR 1.44, 95% CI 1.00–2.08) were independently associated with an increased risk.Conclusions: Female patients had lower rates of fasciotomies, but subsequent higher risk of major amputation/mortality, which may be attributed to inferior results of revascularization. Lower muscle mass and underdiagnosis of ACS could also explain the lower frequency of fasciotomy for female patients. Further studies are needed to better understand gender differences in presentation of ALI, revascularization results and diagnosis of ACS.

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“…In particular, the extent of reduction in serum Alb and Hb levels between the initial and last NST interventions tended to be lower in the early NST intervention group than in the delayed NST intervention group. Although biochemical markers are usually not changed by EN and tend to be affected by the patients' disease status or other confounding factors [36], serum Alb is a relatively sensitive marker for assessing dietary intake and protein deficiency [34,37] and low serum Alb level is associated with anemia and low Hb levels in EN patients [38].…”

Section: Discussionmentioning

confidence: 99%

“…Since EN alone cannot provide sufficient amount of nutrition to meet patients' metabolic or physical need in the long term [25,38], patients tend to be malnourished at the end of tube feeding, as evidenced by the energy deficit [25] and decrease in biochemical parameters such as Alb and Hb levels [38]. The higher energy supply and smaller reduction in Alb and Hb levels in the early NST group than in the delayed NST group indicated that early NST prevented tube feeding-induced nutrition deficit; this may be the reason why both groups had more patients with severe malnutrition at the end of the NST intervention than at the beginning.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Timing of Nutritional Support Team Intervention on Nutritional Status on Patients Receiving Enteral Nutrition

Kim

2021

Clin Nutr Res

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Many hospitalized patients usually have a high risk of malnutrition, which delays the therapy process and can lead to severe complications. Despite of the potential benefits, the effects of timely intervention by nutrition support team (NST) on the nutritional status of admitted patients are not well established. This study aimed to compare the nutritional status between patients with early and delayed NST supports and to assess the effect of the timing of NST support initiation on the nutritional status of enteral nutrition patients. In a simple comparison between the two groups, the early NST intervention group had shorter hospital stays and fewer tube feeding periods than the delayed NST intervention group. The increase in the amount of energy intake from first to last NST intervention was 182.3 kcal in patients in the early NST intervention group, higher than that in patients in the delayed intervention group (p = 0.042). The extent of reduction in serum albumin and hemoglobin levels between the initial and last NST intervention tended to be lower in the early NST intervention group than in the delayed NST intervention group. The mean odds ratio for the patients who were severely malnourished in the early NST intervention group was 0.142 (95% confidence interval, 0.045–0.450) after adjusting for hospital stay and age. The results of this study indicate that early NST intervention can improve patients' overall nutritional status.

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Association of the Presence Anemia and Malnutrition in Hospitalized Patients With Exclusive Enteral Nutrition

Abstract: anemia has an important relation with anthropometric markers that evaluate the depletion of lean mass; the BMI has a strong association with all the anthropometric parameters evaluated, as well as the albumin and capillary blood glucose, except with the values of hemoglobin.

Cited by 5 publications

References 0 publications

Prognostic impact of follow‐up serum albumin after acute myocardial infarction

Prognostic impact of follow‐up serum albumin after acute myocardial infarction

Risk Factors for Fasciotomy After Revascularization for Acute Lower Limb Ischaemia

Effect of the Timing of Nutritional Support Team Intervention on Nutritional Status on Patients Receiving Enteral Nutrition

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