Outcomes of older and younger malnourished and well-nourished patients one year after hospitalization

Abstract

The purpose of this study was to determine the relationship between malnutrition and later health status in old and young patients after hospitalization. Men were evaluated by nine criteria of malnutrition and classified as older (age 65 and older) and younger (younger than 65). About 32% of the younger and 45% of the older men were malnourished. At base-line, malnourished patients had more diagnoses (p less than 0.01) and depressed lymphocyte response to phytohemagglutinin (p less than 0.05). Older malnourished patients also had more depressed chemotaxis results (p less than 0.05). One year later, the malnourished patients still had more markers of malnutrition (p less than 0.001), more diagnostic problems (particularly infections) during the follow-up (p less than 0.01), and depressed lymphocyte response to phytohemagglutinin (p less than 0.05) and increased IgA levels (p less than 0.01). The only deaths (n = 4) occurred among the malnourished older men. Alcoholism in the malnourished young men may have contributed to their continued or recurrent status of protein energy malnutrition. The malnourished old patients could have had less recuperative powers and continued poorer diets. The study suggests malnourished hospitalized patients are at high risk for long-term health problems probably through continued or reoccurring episodes of malnutrition.

The Role of Anthropometry in the Assessment of Malnutrition in the Hospitalized Frail Elderly

“…Nu tritional assessment of the elderly has been studied in hospitalized [1,11,12] nursing home [13,14] and community-dwelling [15,16] populations. Criteria utilized for identi fying impaired nutritional states have varied in the number and types of indicators.…”

“…Agarwal et al [11] defined malnu trition in hospitalized elderly by the presence of an abnormality in any one of the following: % IBW, serum albumin and transferrin, TLC, and anergy. Linn [12] utilized nine markers to identify malnutrition in hospitalized elderly. The varied methodology to diagnose malnu trition in the hospitalized elderly indicates the increased concern for the nutritional status of the patient, but also the lack of standards in the assessment for impaired nutritional states.…”

“…Serum albumin is com monly employed in assessment of nutritional status [3,5,22], A number of studies have found serum albumin to be prognostic for increased morbidity [12,24] and mortality [11,25,26]. The ease and cost-effective man ner of obtaining serum albumin, rather than serum transferrin (a better indicator of early changes in body protein scores), makes it practical in routine assessment, particularly since transferrin is an acute phase reactant and is often elevated in hospitalized patients.…”

Malnutrition in Geriatric Patients: Diagnostic and Prognostic Significance of Nutritional Parameters

“…Bienia et al [4] and Linn [20] described higher mortality rates in malnour ished geriatric patients compared with those who were well nourished. This was also true for our study group: in patients showing mul tiple unsatisfactory values, the mortality rate was well above average (table 6).…”

Low phase angle determined by bioelectrical impedance analysis is associated with malnutrition and nutritional risk at hospital admission

“…4,6 Complications of malnutrition increase therapeutic hospital cost and ultimately the cost of patient rehabilitation. 7 Thus, nutritional risk should be evaluated. The prevalence of poor nutritional status in the different studies 8 shows wide variations depending on the population or type of institution studied, but also on the different diagnostic criteria used to define nutritional status or nutritional risk.…”