Increased Association With Malnutrition and Malnourishment in Older Adults Admitted With Hip Fractures Who Have Cognitive Impairment and Delirium, as Assessed by 4AT

Han, Thang S.; Lisk, Radcliffe; Osmani, Ahmad; Sharmin, Rifat; Gammel, Sarah El; Yeong, Keefai; Fluck, David; Fry, Christopher

doi:10.1002/ncp.10614

Cited by 8 publications

(14 citation statements)

References 39 publications

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“…The same MUST protocol was used by all four hospitals to identify patients at risk of malnutrition. [21][22][23] The information for MUST was recorded routinely by healthcare professionals during hospital admission. This procedure comprises three independent variables: body mass index (BMI [calculated as weight in kilograms divided by height in meters squared]) score (BMI > 20.0 = 0, BMI 18.5-20.0 = 1, and BMI < 18.5 = 2), unplanned weight loss in the previous 3-6 months (weight loss < 5% = 0, weight loss 5-10% = 1, and weight loss > 10% = 2), and acute disease effect score (a score of 2 was added if a patient was recently affected by a disease and there was no nutrition intake or likely to be no nutrition intake for >5 days).…”

Section: Nutrition Statusmentioning

confidence: 99%

Association of risk of malnutrition with adverse outcomes and early support on discharge in acute stroke patients without prestroke disability: A multicenter, registry‐based cohort study

et al. 2021

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Background: Malnutrition in hospitals remains highly prevalent. As part of quality improvement initiatives, the Royal College of Physicians recommends nutrition screening for all patients admitted with acute stroke. We aimed to examine the associations of patients at risk of malnutrition with poststroke outcomes. Methods:We analyzed prospectively collected data from four hyperacute stroke units (HASUs) (2014)(2015)(2016). Nutrition status was screened in 2962 acute stroke patients without prestroke disability (1515 men, [mean ± SD] 73.5 years ± 13.1; 1447 women, 79.2 ± 13.0 years). The risk of malnutrition was tested against stroke outcomes and adjusted for age, sex, and comorbidities.Results: Risk of malnutrition was identified in 25.8% of patients). Compared with well-nourished patients, those at risk of malnutrition had, within 7 days of admission, increased risk of stay on the HASU of >14 days (odds ratio [OR]: 9.9 [7.3-11.5]), disability on discharge (OR

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Section: Nutrition Statusmentioning

confidence: 99%

Association of risk of malnutrition with adverse outcomes and early support on discharge in acute stroke patients without prestroke disability: A multicenter, registry‐based cohort study

et al. 2021

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“…This study also included risk of malnutrition, particularly amongst those with delayed swallow screening, prolonged LOS on HASU and TRC, which has not previously been well-documented. Malnutrition amongst patients admitted with an acute stroke is a significant indicator of post-stroke adverse outcomes including disability, mortality and prolonged LOS [ 16 ]. Few studies have also reported LOS; our observation of a median LOS on HASU of 18 and 6.5 days respectively for HOS and COS patients is very similar that of 17 and 8 days by Saltman et al [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Initially, the patient was given three spoons of water, and if there was no risk of aspiration, the patient was challenged with one cup of water. If successful, a trial was continued with a soft-diet meal [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

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Comparison of characteristics, management and outcomes in hospital-onset and community-onset stroke: a multi-centre registry-based cohort study of acute stroke

et al. 2022

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Objective Hospital-onset stroke (HOS) is associated with poorer outcomes than community-onset stroke (COS). Previous studies have variably documented patient characteristics and outcome measures; here, we compare in detail characteristics, management and outcomes of HOS and COS. Methods A total of 1656 men (mean age ± SD = 73.1 years ± 13.2) and 1653 women (79.3 years ± 13.0), with data prospectively collected (2014–2016) from the Sentinel Stroke National Audit Programme, were admitted with acute stroke in four UK hyperacute stroke units (HASU). Associations between variables were examined by chi-squared tests and multivariable logistic regression (COS as reference). Results There were 272 HOS and 3037 COS patients with mean ages of 80.2 years ± 12.5 and 76.4 years ± SD13.5 and equal sex distribution. Compared to COS, HOS had higher proportions ≥ 80 years (64.0% vs 46.4%), congestive heart failure (16.9% vs 4.9%), atrial fibrillation (25.0% vs 19.7%) and pre-stroke disability (9.6% vs 5.1%), and similar history of stroke, hypertension, diabetes, stroke type and severity of stroke. After age, sex and co-morbidities adjustments, HOS had greater risk of pneumonia: OR (95%CI) = 1.9 (1.3–2.6); malnutrition: OR = 2.2 (1.7–2.9); immediate thrombolysis complications: OR = 5.3 (1.5–18.2); length of stay on HASU > 3 weeks: OR = 2.5 (1.8–3.4); post-stroke disability: OR = 1.8 (1.4–2.4); and in-hospital mortality: OR = 1.8 (1.2–2.4), as well as greater support at discharge including palliative care: OR = 1.9 (1.3–2.8); nursing care: OR = 2.0 (1.3–4.0), help for daily living activities: OR = 1.6 (1.1–2.2); and joint-care planning: OR = 1.5 (1.1–1.9). Conclusions This detailed analysis of underlying differences in subject characteristics between patients with HOS or COS and adverse consequences provides further insights into understanding poorer outcomes associated with HOS.

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“…In another study, researchers highlighted the role of coexisting geriatric syndromes, including cognitive impairment and delirium among older adults hospitalized with hip fractures. They assumed a strong correlation between delirium, cognitive impairment, and malnutrition [ 32 ].…”

Section: Falls and Fractures—consequences Of Malnutritionmentioning

confidence: 99%

Malnutrition in Older Adults—Effect on Falls and Fractures: A Narrative Review

Kupisz-Urbańska

Marcinowska-Suchowierska

2022

Nutrients

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Malnutrition in older adults impacts health status, increased mortality, and morbidity. Malnutrition may increase the development of geriatric syndromes and contribute to a higher prevalence of falls and osteoporotic fractures that lead to loss of independence and an increased rate of institutionalization. The role of malnutrition in the pathogenesis of other geriatric syndromes seems to be well established. However, the data concerning nutritional interventions are confounding. Moreover, long-term undernutrition seems to be one of the factors that strongly influences the efficacy of interventions. This review outlines the current literature on this topic, and aims to guide physicians to make proper decisions to prevent the vicious cycle of falls, fractures, and their negative outcomes in patients with malnutrition.

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Increased Association With Malnutrition and Malnourishment in Older Adults Admitted With Hip Fractures Who Have Cognitive Impairment and Delirium, as Assessed by 4AT

Abstract: Increased association with malnutrition and malnourishment in older adults admitted with hip fractures with cognitive impairment and delirium, as assessed by 4AT. Nutrition in Clinical Practice.

Cited by 8 publications

References 39 publications

Association of risk of malnutrition with adverse outcomes and early support on discharge in acute stroke patients without prestroke disability: A multicenter, registry‐based cohort study

Association of risk of malnutrition with adverse outcomes and early support on discharge in acute stroke patients without prestroke disability: A multicenter, registry‐based cohort study

Comparison of characteristics, management and outcomes in hospital-onset and community-onset stroke: a multi-centre registry-based cohort study of acute stroke

Malnutrition in Older Adults—Effect on Falls and Fractures: A Narrative Review

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