CUMULATIVE ENERGY DEFICIT IN THE FIRST SEVEN DAYS AFTER ADMISSION IS ASSOCIATED WITH POOR OUTCOMES AT THREE MONTHS IN NON-ACUTE HOSPITALIZED OLDER ADULTS

Abstract

Aim: To examine the hypothesis that larger cumulative energy deficit and late initiation of enteral nutrition for older adult patients in non-acute setting is associated with poor outcome at 3 and 6 months later. Methods: This is retrospective study with chart review in a single institute. The consecutive older adult patients (>= 65 years-old) admitted to the institute were included. Dividing all subjects by two categories: take nutrients by mouth (PO) during hospital stay vs. non-PO group, and enteral nutrition (EN) during the first 7 and 14 days after admission vs. non-EN (NEN) group. Between these two groups, demographics, nutritional, and outcomes were compared. Results: 1, PO group showed significantly longer length of hospital stay (p=0.049). 2, NEN group showed significantly larger cumulative energy deficit, longer length of hospital stay, and higher mortality at 3 and 6 months later (p=0.000, p=0.000, p=0.044, and p=0.008, respectively). Conclusion: The larger cumulative energy more than 10, 000 kcal is considered to be associated with poor clinical outcomes, including longer LOS and higher mortality at 3 and 6 months later in the hospitalized older adults (>= 80 years-old). The cumulative energy deficit might be considered in nutritional support even for older adults admitted to non-acute setting to prevent poor outcomes.