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Undernutrition and risk of mortality in elderly patients within 1 year of hospital discharge
Journal article   Open access   Peer reviewed

Undernutrition and risk of mortality in elderly patients within 1 year of hospital discharge

Longjian Liu, Melinda M Bopp, Paula K Roberson and Dennis H Sullivan
The journals of gerontology. Series A, Biological sciences and medical sciences, v 57(11), pp M741-M746
Nov 2002
DOI: https://doi.org/10.1093/gerona/57.11.M741
PMID: 12403803
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1093/gerona/57.11.M741View
Published, Version of Record (VoR) Open

Abstract

Body Mass Index Nutrition Disorders - diagnosis Anthropometry Humans Mortality Risk Factors Biomarkers - analysis Patient Discharge Proportional Hazards Models Male Activities of Daily Living Survival Analysis Aged, 80 and over Female Aged Nutrition Disorders - complications Hospitals, Veterans APACHE
The importance of undernutrition as a determinant of postdischarge mortality among hospitalized elderly people remains controversial. The purpose of this study was to investigate this issue. The study included 660 elderly patients (85% white, 98% men, average age 73 +/- 6 years) discharged from a university-affiliated Department of Veterans Affairs Hospital, who were followed for 1 year. Associations between patient characteristics at hospital discharge and mortality were identified utilizing Cox Proportional Hazards Regression analysis. In the year following hospital discharge, 85 subjects (13%) died. After adjusting for illness severity (Acute Physiology and Chronic Health Evaluation II score) and functional status (Katz Index of Activities of Daily Living score), a body mass index (BMI) </=20 kg/m(2) was strongly associated with mortality (adjusted relative risk, [95% confidence interval] 1.83 [1.17-2.85]), as was more than 10% weight loss in the prior year (2.31 [1.35-3.94]), and weight as percent of usual weight (WPU) </=85% (1.78 [1.14-2.77]). Albumin </=30 g/l was only weakly associated with mortality (1.10 [0.67-1.81]). When all of the putative nutrition variables were included in a multivariable analysis with the two control variables, only BMI followed by WPU </=85% entered the model. Utilizing this model, the predicted probabilities of death at 1 year were calculated for the study subjects and for a hypothetical group of patients who were identical to the study subjects except they were assigned a BMI of 28 kg/m(2) and their WPU was 100%. Compared to 24% of the actual subjects, only 7% of the hypothetical well-nourished patients would have been classified as being at high risk for mortality (a 71% relative reduction). Older patients who have evidence of chronic body mass depletion are at significantly increased risk of mortality within the year following hospital discharge.

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97 citations in Web of Science
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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#2 Zero Hunger
#3 Good Health and Well-Being
#5 Gender Equality

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Collaboration types
Domestic collaboration
Web of Science research areas
Geriatrics & Gerontology
Gerontology
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