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

Jiaojiao Jiang,Birong Dong,Birong Dong,Jing Chen,Jing Chen,Ming Yang,Ming Yang,Lei Zhang,Lei Zhang,Xiaoyi Hu,Xiaoyi Hu,Haozhong Wang,Haozhong Wang

doi:10.1038/s41598-017-04483-1

Jiaojiao Jiang, Birong Dong + Show 11 more

Open Access

https://doi.org/10.1038/s41598-017-04483-1

Copy DOI

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.

Highlights

Malnutrition, known as undernutrition, can be defined as “any nutritional imbalance”[1]
Data needed to assess malnutrition were missing in 16 participants (3%)
This study demonstrated that the prevalence of malnutrition was 15.1% and 10.3% based on the new ESPEN diagnostic criteria and the Mini Nutritional Assessment (MNA) scale, respectively

Summary

Introduction

Malnutrition, known as undernutrition, can be defined as “any nutritional imbalance”[1]. The prevalence of malnutrition increases with age, the number of comorbidities, and level of care[4, 7] It is prevalent in elderly people, especially in hospitalized elderly patients[4, 7]. A validated risk screening tool is recommended to identify individuals “at risk of malnutrition” In those who are at risk of malnutrition, two alternative ways are offered to diagnose malnutrition: 1) body mass index (BMI) 10% indefinite of time (or >5% over the last 3 months) combined with either of the following two items: BMI

Objectives

Results

Discussion

Conclusion