Deaths in nursing homes

Gorzoni, Milton Luiz; Pires, Sueli Luciano

doi:10.1016/s0104-4230(11)70068-9

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…The highest all‐cause mortality rates were observed in underweight subjects, extending to each specific cause. Infections and cardiovascular disease are the leading causes of death in nursing home residents . Both of these mortality causes were significantly elevated in underweight individuals, while at least in RR analyses, overweight and obesity were protective regarding death from infectious diseases compared with normal weight status.…”

Section: Discussionmentioning

confidence: 97%

“…Malnutrition is responsible for the impairment of immune functions . Although urinary tract, skin and soft tissue infections are common, also caused by the high prevalence of pressure ulcers and use of indwelling urinary catheters, pneumonia – frequently originating from aspiration in a highly neurologic and dysphagic population – is the most frequent cause and has the highest mortality . This outcome is likely related also to the paucity of clinical signs characterizing pneumonia in nursing homes .…”

Section: Discussionmentioning

confidence: 99%

“…Although urinary tract, skin and soft tissue infections are common, also caused by the high prevalence of pressure ulcers and use of indwelling urinary catheters, pneumonia – frequently originating from aspiration in a highly neurologic and dysphagic population – is the most frequent cause and has the highest mortality . This outcome is likely related also to the paucity of clinical signs characterizing pneumonia in nursing homes . Finally, although the association between vascular mortality and low body weight is intriguing – as it likely occurs in the absence of metabolic abnormalities – it may be explained by inflammatory and hormonal changes (e.g.…”

Section: Discussionmentioning

confidence: 99%

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Inverse relationship between body mass index and mortality in older nursing home residents: a meta‐analysis of 19,538 elderly subjects

et al. 2015

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Summary Body mass index (BMI) and mortality in old adults from the general population have been related in a U‐shaped or J‐shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic PubMed/EMBASE/CINAHL/SCOPUS search until 31 May 2014 without language restrictions was conducted. As no published study reported mortality in standard BMI groups (<18.5, 18.5–24.9, 25–29.9, ≥30 kg/m2), the most adjusted hazard ratios (HRs) according to a pre‐defined list of covariates were obtained from authors and pooled by random‐effect model across each BMI category. Out of 342 hits, 20 studies including 19,538 older nursing home residents with 5,223 deaths during a median of 2 years of follow‐up were meta‐analysed. Compared with normal weight, all‐cause mortality HRs were 1.41 (95% CI = 1.26–1.58) for underweight, 0.85 (95% CI = 0.73–0.99) for overweight and 0.74 (95% CI = 0.57–0.96) for obesity. Underweight was a risk factor for higher mortality caused by infections (HR = 1.65 [95% CI = 1.13–2.40]). RR results corroborated primary HR results, with additionally lower infection‐related mortality in overweight and obese than in normal‐weight individuals. Like in the general population, underweight is a risk factor for mortality in old nursing home residents. However, uniquely, not only overweight but also obesity is protective, which has relevant nutritional goal implications in this population/setting.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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