Malnutrition: causes and consequences

Saunders, John; Smith, Trevor

doi:10.7861/clinmedicine.10-6-624

Cited by 312 publications

(250 citation statements)

References 5 publications

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“…The cardiac dysfunction in malnourished individuals has been related to the reduction of the cardiac muscle mass [18,19]. Changes in the cardiac system, in malnourished infants, were related to decreased myocardial mass, as represented by shorter intra-…”

Section: Discussionmentioning

confidence: 99%

Functional status and heart rate variability in end-stage liver disease patients: Association with nutritional status

et al. 2015

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The study evaluated 42 patients with liver disease (62% men) and malnutrition was found in 62% of this population. The malnourished participants presented with reduced functional status, 41% decreased SDNN, and 14% greater CWI compared with well-nourished individuals (P < 0.05). Additionally, the CWI was negatively associated to SDNN (r = 0.414; P < 0.05) and gait speed (r = 0.598; P < 0.05), especially in malnourished individuals (r = 0.650; P < 0.05). These data indicate that malnourished patients with liver disease have higher cardiovascular risk related to reduced functional status, which may be associated to poor outcomes during the course of the disease before and after transplant. Another relevant aspect is that the 6MWT associated to HRV could be a useful tool to screen liver disease patients who have a higher risk for cardiovascular complications.

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Section: Discussionmentioning

confidence: 99%

Functional status and heart rate variability in end-stage liver disease patients: Association with nutritional status

et al. 2015

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“…In general, this is where clarity ends [39][40][41]. Although the changes due to malnourishment are poorly understood, there is Median interquartile range unless otherwise specified consensus that these changes eventually lead to bad clinical outcomes including mortality [42,43]. Malnutrition can lead to immune suppression, possibly as a result of micronutrient or protein deficiency, hence increased susceptibility to infection [44,45].…”

Section: Discussionmentioning

confidence: 99%

Causal impact of malnutrition on mortality among adults hospitalized for medical illness in sub-Saharan Africa: what is the role of severe sepsis?

et al. 2015

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Background: In sub-Saharan Africa, malnutrition is associated with mortality in adults hospitalized for medical illness. However, it remains unclear whether this association is causal, and if causal, what the potential mediators are. We assessed whether malnutrition is causally related to mortality among hospitalized adults, and whether severe sepsis plays a mediating role. Methods: We analyzed data from a cohort study of adults hospitalized for any medical illness in Uganda. We measured malnutrition using mid-upper arm circumference (MUAC). We used a directed acyclic graph to identify a minimum sufficient adjustment set of confounders in order to estimate the overall effects of malnutrition on mortality. We then used recently developed statistical methods to determine whether mortality in malnourished patients is mediated by severe sepsis. Results: We analyzed data of 318 adults. Median age was 37 (interquartile range [IQR] 27 to 56), and 25 % (n = 80) were malnourished according to MUAC. Malnourished patients were more likely to be HIV positive (64 % versus 39 %, p < 0.001), more severely ill (median MEWS 5, IQR 3 to 7 versus 4, IQR 2 to 6, P = 0.003), and to have both any sepsis (66 % versus 39 %, p < 0.001) and severe sepsis (51 % versus 20 %, P < 0.001) compared to normally nourished patients. After adjusting for the modified early warning score at admission, tuberculosis, HIV status, education status, age, and sex, malnourished patients remained at 3.0-fold (95 % CI: 1.5, 6.1, P = 0.002) increased odds of having severe sepsis at admission, and at 2.1-fold (95 % confidence interval [CI]: 1.2, 3.7, P = 0.008) increased odds of dying by 30 days post-admission. Only a small proportion of the effects of malnutrition on mortality were mediated by severe sepsis; overall, malnutrition increased the risk of death by 16.8 percentage points (95 % CI: 4.1, 29.4), but only 1.1 percentage points (95 % CI: −2.1, 4.4) absolute risk difference was mediated by severe sepsis. Conclusion: Our data suggest that malnutrition increases mortality in adults hospitalized for medical illness; thus, interventions against malnutrition in this population may reduce mortality. As severe sepsis did not mediate a large proportion of the effects of malnutrition on mortality, future studies are recommended to investigate other potential mediators.

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“…[3][4][5] Na década de setenta, o estudo realizado por Bollet e Owens 6 se destacou pela elevada prevalência de desnutrição em pacientes hospitalizados por diversas doenças. Mesmo após quarenta anos, estudos atuais 7-9 vêm corroborando resultados similares e demonstrando que a desnutrição hospitalar continua a ser um problema atual e recorrente, independentemente do nível de desenvolvimento do país.…”

Section: Introductionunclassified

“…[11][12][13][14] A resposta ao estresse gerado pela doença ou por outras causas da desnutrição, como a ingestão diária alimentar dimiuída em longo prazo, faz com que o organism utilize reservas do tecido muscular e adipose para produzir energia, levando a mudanças na composição corporal, redução da funcionalidade, alterações sanguíneas, nos demais órgãos e sistemas e a um estado metabólico frágil. 5,15 Este estudo tem como objetivo determinar a frequência de desnutrição na admissão hospitalar e correlacionar a desnutrição com o tempo de permanência hospitalar e a mortalidade de pacientes clínicos. 16 A i dentificação do risco nutricional foi classificada em: sem risco nutricional ou com risco nutricional.…”

Section: Introductionunclassified

Desnutrição Na Admissão, Permanência Hospitalar E Mortalidade De Pacientes Internados Em Um Hospital Terciário

Teixeira

Miranda²,

Baptista³

2016

DEMETRA

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Malnutrition: causes and consequences

Cited by 312 publications

References 5 publications

Functional status and heart rate variability in end-stage liver disease patients: Association with nutritional status

Functional status and heart rate variability in end-stage liver disease patients: Association with nutritional status

Causal impact of malnutrition on mortality among adults hospitalized for medical illness in sub-Saharan Africa: what is the role of severe sepsis?

Desnutrição Na Admissão, Permanência Hospitalar E Mortalidade De Pacientes Internados Em Um Hospital Terciário

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