Correlation of Pressure Sores and Nutritional Status

Pinchcofsky-Devin, G; Kaminski, Mitchell V.

doi:10.1111/j.1532-5415.1986.tb03411.x

Cited by 286 publications

(108 citation statements)

References 7 publications

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“…Malnutrition in the long term residential care setting has been extensively documented to be a prevalent problem, with adverse effects on morbidity and mortality (Munci & Carbonetto, 1982;Pinchcofsky-Devin & Kaminski Jr, 1986;Sandman et al, 1987;Rudman & Feller, 1989;Thomas et al, 1991;Abbasi & Rudman, 1993;Sullivan & Walls, 1994;Morley & Silver, 1995). The causes are largely reversible (Morley & Kraenzle, 1994;Morley & Silver, 1995;Sullivan, 1995), and nutritional assessment has been incorporated as one of several performance indicators linked to reimbursement in countries such as the US (Hawes et al, 1997), as part of the Resident Assessment Instrument (Brown, 1995).…”

Section: Introductionmentioning

confidence: 99%

Low staffing level is associated with malnutrition in long-term residential care homes

et al. 2005

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Objective: To determine if staffing level is associated with poor nutrition in the long-term residential care setting, adjusting for other confounding factors. Design: Cross-sectional survey. Setting: In total, 14 residential care facilities in Hong Kong, stratified by nature (government subvention or for-profit) to reflect the overall proportion in Hong Kong. Subjects: A total of 1914 subjects were assessed, using the Resident Assessment Instrument (RAI) 2.0. The response rate was 95% (1820 subjects), of which 1699 subjects had complete nutritional information. Intervention: Body mass index (BMI) was calculated by weighing and height measurement, and arm span was used if the subject could not stand. Subjects who were receiving parenteral or enteral nutrition via nasogastric of enterostomy tubes were excluded. A history of weight loss of 5% in the past month or 10% in the past 6 months, leaving 25% of food uneaten, and BMI o18.5 kg/m 2 were examined as nutritional indicators. Association with age, gender, functional disability, oral problems, taste problems, presence of physical diseases and psychological well-being was examined using w 2 -test, and multiple logistic regression. Results: In all, 26% of residents had a BMI o18.5 kg/m 2 , with a higher prevalence in the for-profit homes. History of weight loss and the record that 25% of food was left uneaten were poor indicators of low BMI. Multivariate analysis showed that having chronic obstructive airways disease, requiring help with feeding, being female, older age, were factors associated with an increased risk of poor nutrition, while being independent in activities of daily living and higher staff levels were associated with a reduced risk. Conclusion: Poor nutrition is a persistent problem in the long-term care setting, and inadequate staffing levels may be a reversible cause. However, resource limitations may render efforts at improvement difficult. Sponsorship: SK Yee Memorial Fund.

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Section: Introductionmentioning

confidence: 99%

Low staffing level is associated with malnutrition in long-term residential care homes

et al. 2005

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“…[12][13][14] Cachexia has been associated with increased numbers of infections, decubitus ulcers, and even death. [15][16][17] In patients with cancer cachexia, the degree of depletion of lean body mass and visceral protein is associated with reduced survival. 18 This study was undertaken because we have seen a number of patients with cGVHD who are many years post SCT (5 or 10 years) and who are either losing weight or have been unable to regain weight since their transplant.…”

mentioning

confidence: 99%

Weight loss and malnutrition in patients with chronic graft-versus-host disease

Jacobsohn

Margolis

Doherty

et al. 2002

Bone Marrow Transplant

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Summary:It is well known that weight loss occurs in patients with chronic graft-versus-host disease. However, the severity and frequency of weight loss in this population have not been adequately described. Recent data suggest that a body-mass index (BMI) below 21.9 is an independent risk factor for mortality. In our analysis we have shown that out of 93 patients with cGVHD, 43% are malnourished as evidenced by a BMI less than 21.9 and 14% are severely malnourished (BMI less than 18.5). In addition, there is a clear trend showing that patients with active, ongoing cGVHD have lower BMIs (P = 0.02). Furthermore, we show that many symptoms thought to contribute to weight loss in patients with cGVHD, such as odynophagia and oral sensitivity, are not related to weight loss in our population. We conclude that, in all likelihood, unknown causes still exist that are responsible for weight loss in this group of patients. Elevated resting energy expenditure and elevated serum tumor necrosis factor-␣ are potential contributors to weight loss that will be tested in future studies. We also conclude that treating cGVHD aggressively may help reverse weight loss and malnutrition, which may be independent risk factors for mortality in this population.

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“…The conclusion was that the development of pressure ulcers correlates with nutritional deficiencies. 12 Not only is nutritional intake essential for proper wound healing, but wound healing itself increases the demand for calories and protein. In a comparison of 14 tube-fed nursing home patients with pressure ulcers and 12 tube-fed patients without ulcers (the controls), despite increased calorie and protein intake, the pressure ulcer patients had worse biochemical measures of nutritional status and lower serum albumin and hemoglobin levels.…”

Section: Nutritionmentioning

confidence: 99%

Wound Healing and Nutrition: Going Beyond Dressings With a Balanced Care Plan

Gruen¹

2010

The Journal of the American College of Certified Wound Speciali

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As the largest organ of the body, the human skin protects all subcutaneous tissues. Despite its many attributes, the skin is vulnerable to pressure ulcers. The number of pressure ulcers and venous leg ulcers is on the rise, but healing rates have not improved over the past decade. The reason may be a tendency to focus on one or two fundamentals of wound healing, but not on all 3 fundamentals equally. The 3 fundamentals of wound healing are (1) pressure relief and nursing care, (2) dressings, and (3) nutrition. Nutrition is the area that is most often overlooked, which commonly causes the care plan to be out of balance. In the United States, few clinicians would consider malnutrition to be an issue in the homecare and long-term care setting, yet nutritional status and risk for pressure ulcer formation are well documented and strongly correlated. Our aging population will continue to survive previously catastrophic events, only to present with pressure ulcers or the potential for developing pressure ulcers. Clinicians caring for residents with pressure ulcers must strike a balance between pressure relief, dressings, and nutrition. Functional gastrointestinal-tract impairments must be diagnosed and addressed. Wounds must be treated aggressively with high-protein calorically-balanced diets because wounds heal from the inside out.

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Correlation of Pressure Sores and Nutritional Status

Cited by 286 publications

References 7 publications

Low staffing level is associated with malnutrition in long-term residential care homes

Low staffing level is associated with malnutrition in long-term residential care homes

Weight loss and malnutrition in patients with chronic graft-versus-host disease

Wound Healing and Nutrition: Going Beyond Dressings With a Balanced Care Plan

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