Predicting long-term mortality in hospitalized elderly patients using the new ESPEN definition

Abstract

The European Society of Clinical Nutrition and Metabolism (ESPEN) recently published new diagnostic criteria for malnutrition. The aim of this study was to evaluate whether malnutrition by the new ESPEN diagnostic criteria can predict long-term mortality in elderly inpatients. We conducted a prospective study in the acute geriatric wards. Malnutrition was defined according to the new ESPEN criteria and the Mini Nutritional Assessment (MNA), respectively. The survival status was determined by telephone interviews at 3-years. A total of 437 elderly adults were included. According to the new ESPEN criteria, 66 participants (15.1%) were malnourished. According to the MNA, 45 participants (10.3%) were identified as malnourished. The 3-year all-cause mortality was 41.7% in participants with malnutrition defined by the ESPEN criteria and 15.3% in participants without malnutrition (p < 0.001). After adjusting for relevant confounders, malnutrition defined by the ESPEN criteria was a significant predictor of 3-year all-cause mortality (hazard ratio [HR] 2.98, 95% confidence interval [CI] 1.87–4.86). However, malnutrition defined by the MNA was not a significant predictor of 3-year all-cause mortality (HR 1.67, 95% CI 0.89–2.31). In conclusion, the new ESPEN diagnostic criteria for malnutrition are reliable in predicting 3-year all-cause mortality among elderly inpatients.

Prognostic Factors for the Survival of Elderly Patients Who Were Hospitalized in the Medical Ward of Our Hospital in Japan

“…Nutritional status is an indicator of the prognosis of the elderly [14]. Additionally, Hypoalbuminemia is an indicator of nutritional assessment and prognostic prediction [15].…”

Prognostic Value of the ESPEN Consensus and Guidelines for Malnutrition: Prediction of Post‐Discharge Clinical Outcomes in Older Inpatients

“…Malnutrition is associated with poor functional status and increased mortality in older people . The main consequences of malnutrition and its related syndromes, such as frailty or sarcopenia, include increased risks of infections, loss of independence, worsening health‐related quality of life, and death . Given the lack of consensual malnutrition guidelines, the European Society for Clinical Nutrition and Metabolism (ESPEN) recently made an effort to establish a definition of malnutrition that would be applicable in all adult age ranges and healthcare settings, independent of etiology .…”

“…The ESPEN consensus definition of malnutrition has been applied in both acute and postacute care . In a large population of hospitalized older patients with diabetes, malnutrition lengthened the hospital stay, increased the probability of in‐hospital death by a factor of 2.7, and decreased the probability of being discharged home rather than to an institution .…”

“…[1][2][3] The main conse-quences of malnutrition and its related syndromes, such as frailty or sarcopenia, include increased risks of infections, 4,5 loss of independence, 6 worsening health-related quality of life, 7 and death. [8][9][10][11] Given the lack of consensual malnutrition guidelines, the European Society for Clinical Nutrition and Metabolism (ESPEN) recently made an effort to establish a definition of malnutrition that would be applicable in all adult age ranges and healthcare settings, independent of etiology. 1 The ESPEN consensus of malnutrition guidelines on definition and diagnoses has provided clinicians and researchers a practical tool for the hierarchic organization of nutrition disorders, nutritionrelated conditions, and nutrition-related syndromes.…”

“…1 The ESPEN consensus of malnutrition guidelines on definition and diagnoses has provided clinicians and researchers a practical tool for the hierarchic organization of nutrition disorders, nutritionrelated conditions, and nutrition-related syndromes. 2 The ESPEN consensus definition of malnutrition has been applied in both acute [11][12][13] and postacute care. 14,15 In a large population of hospitalized older patients with diabetes, malnutrition lengthened the hospital stay, increased the probability of in-hospital death by a factor of 2.7, and decreased the probability of being discharged home rather than to an institution.…”