Malnutrition Status Research Articles

Frailty and Malnutrition as Predictors of Major Complications Following Posterior Thoracolumbar Fusion in Elderly Patients: A Retrospective Cohort Study

Background ContextThe number of elderly patients with degenerative spinal deformity (DSD) is increasing, and posterior thoracolumbar fusion surgery is an effective treatment option, but there are often postoperative major complications, which may hinder the benefit for elderly patients. Currently, there is no consensus on the best risk assessment technique for predicting major complications in elderly patients undergoing long-segment fusion surgery. PurposeThis study constructs a risk assessment model using the Modified 5-Item Frailty Index (mFI-5) and serum albumin and evaluates its predictive value. Study DesignThis is a retrospective analysis of a prospectively established database of DSD. Patient SampleConsecutive patients (aged 65 and older) who underwent open posterior thoracolumbar fusion surgery for DSD between April 2018 and December 2023 were included. Outcome MeasuresOutcome measures included postoperative major complications, length of hospital stay [LOS], readmission and reoperation within 30 days, discharge disposition, physiological function recovery. MethodsThe study reviewed consecutive patients who underwent open posterior thoracolumbar fusion surgery for DSD. Patients were divided into three groups based on the presence or absence of frailty or frailty combined with malnutrition. Spearman ρ analysis was used to assess the correlation between mFI-5 and serum albumin levels. Univariate analyses and multivariate logistic regression were conducted to explore the relationship between frailty and malnutrition defined by mFI-5 and serum albumin and major postoperative complications. Finally, the Receiver Operating Characteristic (ROC) curve was used to evaluate the predictive value of this model for major complications. ResultsCompared to the Normal group (n = 59), both the Frailty group (n = 121) and the Frailty and Malnutrition group (n = 50) had higher rates of major complications (21.5% vs. 8.5%, p = .035; 28% vs. 8.5%, p = .002). Multivariate logistic regression showed that frailty and malnutrition status, higher ASA score, and more bleeding were independent predictors of major postoperative complications. The ROC curve demonstrated that frailty combined with malnutrition defined by mFI-5 and serum albumin had a larger area under the curve compared to mFI-5 or serum albumin alone (AUC: 0.676; 95% CI: 1.101-14.129; p < .001). ConclusionsCompared to considering frailty or malnutrition alone, the combined assessment of frailty and malnutrition using mFI-5 and serum albumin is valuable in predicting major complications in elderly patients undergoing posterior thoracolumbar fusion surgery. Level of evidenceIII

Malnutrition and Growth Failure in Cyanotic and Acyanotic Congenital Heart Diseases with and Without Pulmonary Hypertension

Objective: To determine the status of malnutrition and growth failure in cyanotic and acyanotic congenital heart diseases with and without pulmonary hypertension. Study Design: Cross sectional study. Place and Duration of Study: Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Tando Muhammad Khan, Pakistan, from Jan 2020 to Oct 2021. Methodology: A total of 250 children, with echocardiography confirmed congenital heart disease, of both genders and aged below 5 years were included. All cases were divided into 4 groups, these being, acyanotic congenital heart disease with PH, acyanotic congenital heart disease without pulmonary hypertension, cyanotic congenital heart disease with pulmonary hypertension and cyanotic Congenital heart disease without pulmonary hypertension. Gender, age, body weight, height, area of residence and malnutrition status were determined in all cases and compared in between study groups. Results: There were 41(16.4%) patients with acyanotic PH, 115(46.0%) acyanotic without PH, 34(13.6%) cyanotic with pulmonary hypertension and 60(24.0%) cyanotic without pulmonary hypertension among a total of 250 cases. Significant differences were noted in terms of age, weight, and height among different study groups (p&lt;0.001). Nutritional status as normal was noted in 51(20.4%) cases, mild malnutrition in 50(20.0%), moderate malnutrition in 65(26.0%) and 84(33.6%) with severe malnutrition. Children having cyanotic congenital heart disease and pulmonary hypertension were also found to have failure to thrive (p=0.009). Conclusion: Malnutrition and growth failure were found to be very prevalent among children with CHDs under the age of 5 years. Malnutrition was significantly more pronounced among children having cyanotic CHDs with PH.

Prognostic value of serum 25-hydroxyvitamin D levels and malnutrition status on postoperative complications in patients following laryngectomy with neck dissection.

Postoperative complications (PCs) following total laryngectomy remain a significant challenge, with recent investigations directed toward the impact of nutrition status and vitamin D deficiency. To elucidate the association between preoperative vitamin D level status, malnutrition risk score, and surgical and survival outcomes in patients with advanced laryngeal cancer following total laryngectomy. Prospective cohort study. Sixty-four patients with advanced laryngeal carcinoma treated with total laryngectomy were included in the study. Serum levels of 25(OH) D3 were measured employing a commercial chemiluminescent immunoassay kit, while nutrition status was evaluated using the nutrition risk index (NRI) and Malnutrition universal screening tool (MUST). The mean serum 25(OH) D level was 37.1 ± 19.4 nmol/L (range 11.0-100.6 nmol/L), with 47% of patients exhibiting vitamin D deficiency and 31% displaying insufficiency. Medium/high MUST score had 53% of patients, and moderate/severe NRI was verified in 48% of patients. Univariate logistic regression analysis identified MUST score, GPS score, neutrophil-to-lymphocyte ratio, and circulating 25(OH) D levels as predictive for the occurrence of PCs. In multivariate analysis, MUST score and circulating 25(OH) D levels remained significantly associated with PCs. Patients with high nutrition risk had significantly lower two-year OS rates compared to the medium and low nutrition risk groups, respectively (30% vs. 62% and 83%, p = 0.010). Early identification of malnourished or patients with vitamin D deficiency and those who would benefit from specific nutritional support could be beneficial for minimizing the risk of development of surgical complications and help improve our clinical outcomes.

Prevalence of Malnutrition and Micronutrient Deficiencies in Older Adults with Ulcerative Colitis.

The nutritional status and consequences of malnutrition among older adults with ulcerative colitis (UC) are not known. We conducted a retrospective study of patients 65years ≥ with Ulcerative colitis (UC). Malnutrition was defined using the European Society for Clinical Nutrition and Metabolism (ESPEN) definition. Eight micronutrients and nutrition-related outcomes were measured. The Saskatchewan Inflammatory Bowel Disease-Nutrition Risk Tool was utilized to identify patients at risk for malnutrition. Data were summarized using descriptive statistics. Characteristics of patients with and without malnutrition were compared using Chi-Square test or Fisher's exact tests (analysis of variance for age). Two-hundred and ninety patients with a mean age of 73.4years were included. 54% of patients had moderate-to-severe UC, with 52% receiving advanced therapy. Fifty-one patients (18%) met criteria for malnutrition, 17% were moderate-high risk for malnutrition, and 87% were low risk. Two-hundred and twenty patients (76%) had at least one micronutrient deficiency: 38% vitamin D, 43% iron, and 11% B12. Half of patients had osteoporosis or osteopenia (49%), however, only 39% of high-risk patients had undergone a DEXA scan. The majority of patients were not found to have malnutrition, however, the prevalence of micronutrient deficiencies among older adults with UC was high. This population is at particularly high risk for bone-related disease, yet a significant proportion of patients are not undergoing guideline-directed bone density testing. These findings illustrate the need for regular screening for malnutrition, micronutrient deficiency, and bone-related disease in older adults with UC.

Association between malnutrition status and total joint arthroplasty periprosthetic joint infection and surgical site infection: a systematic review meta-analysis

BackgroundMalnutrition is a state resulting from lack of intake or uptake of nutrition. Investigating the association between malnutrition and postoperative complications is essential for enhancing patient outcomes in total joint arthroplasty (TJA). This meta-analysis aimed to investigate the impact of malnutrition on the incidence of surgical site infections (SSIs) and periprosthetic joint infections (PJIs) following TJA.MethodsThe data were searched from databases including PubMed, Embase, Web of Science, and Cochrane Library inception through July 19 2023, without time restrictions. Inclusion criteria focused on studies examining malnutrition as a risk factor for SSIs and PJIs postarthroplasty, providing sufficient data for calculating odds ratios (ORs) and 95% confidence intervals (CIs). Methodological quality was assessed using the Newcastle‒Ottawa Scale, and statistical analyses were executed in Stata version 17.ResultsA total of 1,025 articles were screened, and 9 studies satisfying the predefined inclusion criteria were consequently selected for this meta-analysis. Studies indicated that malnutrition is significant factor to the heightened incidence of both SSIs and PJIs following TJA procedures. Our pooled results yielded aggregated ORs of 2.60 for SSIs and 3.44 for PJIs, with respective 95% CIs of 2.10–3.10 and 2.35–4.53. The heterogeneity of malnutrition as a risk factor for postoperative SSI was I2 = 0.0% (p = 0.592), and for PJI was I2 = 0.0% (p = 0.422). Egger’s linear regression test showed no significant publication bias (p > 0.05).ConclusionsMalnutrition is a significant risk factor for SSIs and potentially PJIs in patients undergoing TJA. Preoperative optimization strategies targeted at malnourished patients are suggested to minimize postoperative complications clinically.

Predictive value of geriatric nutritional risk index in cardiac and cerebrovascular events after endovascular aortic aneurysm repair.

To evaluate the effect of malnutrition assessed by the Geriatric Nutritional Risk Index (GNRI) on major adverse cardiac and cerebrovascular events (MACCE) in the elderly patients after endovascular aortic aneurysm repair (EVAR). This was a retrospective cohort study of elderly patients who underwent EVAR in a tertiary hospital. Malnutrition status was assessed by the GNRI. The primary outcome was MACCE. The predictive ability of the GNRI was compared with both the Revised Cardiac Risk Index (RCRI) and the modified Frailty Index (mFI) using Receiver operating characteristic (ROC) curve. A total of 453 patients underwent EVAR November 2015 and January 2020 was retrospectively analyzed, equally divided into three (low/medium/high) groups according to GNRI values which ranked from low to high. Five (1.10%) patients were lost in follow-up after surgery, and the median length of follow-up was 28.00 (15.00-47.00) months. The high GNRI values reduced length of hospital stay following EVAR in comparison to patients in low GNRI values group (β 9.67, 95% CI 4.01-23.32, p = 0.0113; adjusted β -1.96, 95% CI -3.88, -0.05, p = 0.0454). GNRI status was associated with a significantly increased risk of long-term mortality after EVAR (Medium GNRI, unadjusted HR 0.40, 95%CI 0.23-0.70, p = 0.0014; adjusted HR 0.47, 95%CI 0.26-0.84, p = 0.0107; high GNRI, 0.27 95%CI 0.14-0.55; p = 0.0003; adjusted HR 0.32 95%CI 0.15-0.68, p = 0.0029). Both medium and high GNRI values were linked to significantly reduced risks of MACCE compared to low GNRI score patients (Medium GNRI, unadjusted HR 0.34, 95%CI 0.13-0.88, p = 0.00265; adjusted HR 0.37, 95%CI 0.14-0.96, p = 0.0408; High GNRI, 0.26 95%CI 0.09-0.78; p = 0.0168; adjusted HR 0.21 95%CI 0.06-0.73, p = 0.0029). Compared with the RCRI and mFI, the GNRI had better discrimination in predicting long-term MACCE. An area under the curve (AUC) for GNRI mFI, and RCRI is 0.707, 0.614 and 0.588, respectively. (Z statistic, GNRI vs. mFI, p = 0.0475; GNRI vs. RCRI, p = 0.0017). Malnutrition assessed by the GNRI may serve as a useful predictor of long-term MACCE in elderly patients after EVAR, with preferable discrimination abilities compared with both RCRI and mFI.

Correlation between Iron Consumption, Hemoglobin Level, and Nutritional Status on the Physical Fitness of Young Women at MA Al-Irsyad Gajah

Background: Good nutritional status, normal hemoglobin levels, and adequate iron consumption will help a person achieve good physical fitness. Lack of iron consumption causes a decrease in hemoglobin production. Low levels of hemoglobin cause disruption of oxygen transport to whole body associated with energy production. Malnutrition or excess nutritional status causes a person to have difficulty moving, which results in a lower level of physical fitness. Objectives: To determine the relationship between iron consumption, hemoglobin level and nutritional status on the physical fitness of female adolescents. Methods: The study used a cross-sectional design, with total sample of 65 respondents. The data were nutritional status from BMI/U, hemoglobin levels using the Easytouch GCHb (Glucose, Cholesterol, and Hemoglobin) tool, iron consumption using food recall, and physical fitness measured using beep test. Bivariate analysis was measured by Gamma correlation test and ordinal logistic regression test for multivariate analysis. Results: Most of respondents had good nutritional status (55.4%), normal hemoglobin levels (69.2%), good iron consumption (58.5%), and sufficient physical fitness (60%). The results of bivariate analysis showed that nutritional status did not correlate with physical fitness (p=0.905). Meanwhile, hemoglobin level and iron consumption correlated with physical fitness (p=0.004). Multivariate analysis explained that hemoglobin levels had a 1.73 effect on physical fitness compared to iron intake which influenced physical fitness by 1.1 times. Conclusions: There is a correlation between iron consumption and hemoglobin levels with physical fitness. There is no correlation between nutritional status and physical fitness.

Peripheral neuropathy and associated factors among children living with HIV on antiretroviral therapy in Gamo zone, Southern Ethiopia: an institution-based cross-sectional study

BackgroundPeripheral neuropathy (PN) is a common neurological complication of HIV (Human Immunodeficiency Virus) that can significantly affect patients’ quality of life. In Ethiopia, children living with HIV are at an increased risk of developing peripheral neuropathy due to comorbidities such as anemia, tuberculosis, malnutrition, and poor socio-economic status. Our study aims to evaluate the prevalence of peripheral neuropathy among children living with HIV in Ethiopia using a simple clinical screening tool.MethodsA health institution-based cross-sectional study was conducted among 148 children aged 5 to 18 years living with HIV who are receiving treatment at the antiretroviral therapy (ART) clinic of the randomly selected public health institutions in the Gamo zone. An interview and neurologic examination were conducted. A binary logistic regression model was used to identify factors associated with the outcome variable. Variables with p-value < 0.25 in the bi-variable logistic regression analysis were entered and checked for association in a multivariable logistic regression model. The level of statistical significance was declared at the p-value < 0.05.ResultIn this study, 148 children participated, making a response rate of 97.5%. The mean ± standard deviation (SD) age of the respondents was 15.03 ± 2.99 years, and 81(54.7%) were male. The magnitude of PN was 20.9% (31/148). Children in the age category of 15–18 (adjusted odds ratio (AOR) = 1.88, 95%CI; 1.24–4.60), low BMI for age (AOR = 1.66, 95%CI; 1.12–4.15), last exposure to isoniazid within 1 year (AOR = 2.31, 95%CI; 1.12–8.53). Longer duration of HIV illness (AOR = 2.17, 95%CI; 1.54–4.64), and past tuberculosis (TB) treatment (AOR = 2.11, 95%CI; 1.08–7.48) were significantly associated factors with peripheral neuropathy.ConclusionOur analysis revealed that being in the age category of 15–18 years, low BMI for age, Isoniazid exposure, longer Duration of HIV illness, and past TB treatment were significantly associated with peripheral neuropathy in children living with HIV. These disease-related factors may contribute to the development and progression of peripheral neuropathy in this population.Clinical trial numberNot applicable.

MODEL INTERVENSI SUPPORTIVE EDUCATIVE SYSTEM BERBASIS INTEGRASI SELF CARE TERHADAP PENGETAHUAN DAN PRAKTIK PEMBERIAN MAKAN PADA IBU BALITA GIZI KURANG

The nutritional status of children under five is a reflection of the nutritional status of the community, nutritional problems arise if the intake of nutrients consumed with nutritional needs is not appropriate. Malnutrition status in toddlers has a negative impact on growth disorders and causes low cognitive abilities and Intelligence Quotient values. Supportive educative system is a method of education or providing education using various methods such as teaching, guiding, and providing environment. The purpose of this study was to analyze the knowledge and practice of feeding underweight mothers before and after being given a supportive educative system intervention based on self care integration. The type of research used is a quasi-experimental research design with one group pretest posttest design. The population in this study were all underweight children under five years of age in the working area of ​​the Magepanda Health Center as many as 36 people, the sampling technique in this study was using a non-probability sampling technique by means of saturated sampling. The instrument for measuring feeding practices was measured using a modified questionnaire from the Child Feeding Questionnaire. Data collection includes pretest, intervention and posttest. Wilcoxon test results show that before and after being given the intervention Supportive Educative System Based on Integration of Self Care and Family Centered Nursing gives a price (p-value 0.000 less than = 0.05), then Ho is rejected. Ha is accepted. This shows that there is a significant effect caused by the intervention of the Supportive Educative System Based on Integration of Self Care and Family Centered Nursing.

Measurement of mid-upper arm circumference to screen for childhood malnutrition: General applicability and use in special populations.

Since the development of consensus-recommended indicators for pediatric malnutrition in 2014, screening and diagnosis of pediatric malnutrition have improved, but the indicators are not always used; malnutrition continues to be underdiagnosed in some community and healthcare settings. In particular, mid-upper arm circumference (MUAC) is underused as a screening indicator for pediatric malnutrition, despite its unique advantages and usefulness in several clinical situations. In December 2022, a scientific roundtable was held to bring together several experts in pediatric malnutrition. One of the goals of the scientific roundtable was to discuss the clinical use of anthropometric measures as screening tools for pediatric malnutrition status, with a focus on the use of MUAC. This article arose from that event and is intended as an educational tool to aid clinicians in implementing MUAC measurements. In addition to describing the use of MUAC as a screening tool, the article discusses several clinical situations in which MUAC is especially useful. Additionally, the article reviews practical aspects of measuring and interpreting MUAC values, provides links to additional educational resources, and briefly reviews areas in which further research is needed regarding the use of MUAC for screening of nutrition status in children.

Factors Influencing Malnutrition Among Older Adult Residents in the Western Region of Saudi Arabia: Sex Differential Study.

The global population of older adults is on the rise. As people age, their physical functions gradually decline, leading to a decrease in the overall functioning of different organ systems. Due to these changes, older individuals are at a higher risk of encountering various adverse health outcomes and complications, such as malnutrition. This study aims to investigate the prevalence of malnutrition and its associated factors among older adults dwelling in the western region of Saudi Arabia. We have analyzed these factors separately for both men and women to understand any potential sex differences. A nonrandomized cross-sectional study was conducted for older adults aged ≥60 years in the western region of Saudi Arabia. Personal information was obtained through a closed questionnaire. The Mini Nutritional Assessment Short Form was used to determine the malnutrition status of older adults. Consequently, the individuals were divided into 2 groups: normal and malnourished. To assess the risk factors related to malnutrition, the odds ratio (OR) and 95% CI were determined using a binary logistic regression. The prevalence of malnutrition in men and women was around 7% and 5%, respectively. Potential risk factors related to malnutrition in men were higher age (OR 1.263, 95% CI 1.086-1.468; P=.002), being widowed (OR 8.392, 95% CI 1.002-70.258; P=.049), and having dental problems (OR 9.408, 95% CI 1.863-47.514; P=.007). On the other hand, risk factors associated with malnutrition in women were lower BMI (OR 0.843, 95% CI 0.747-0.952; P=.006) and being disabled (OR 18.089, 95% CI 0.747-0.952; P=.006). The findings of this study provide important insights into the risk factors for malnutrition among older adults in the western region of Saudi Arabia. While the overall prevalence of malnutrition was relatively low, the analysis revealed distinct risk factors for older men and women. Interventions developed based on the identified risk factors may prove effective in addressing the issue of malnutrition within this population.

Insights into the associated risk factors of malnutrition among nursing home residents: A longitudinal study

Background & AimsMalnutrition often remains undetected in older persons, leading to increased health problems and comorbidity, prolonged hospital stays and readmissions. In 2020, data from the interRAI Home Care (interRAI HC) instrument was used to determine malnutrition status according to some of the criteria of the Global Leadership Initiative on Malnutrition (GLIM). The interRAI HC instrument showed to be effective as a screening tool for the risk of malnutrition. The goal of the present study is to use the interRAI Long Term Care Facilities (interRAI LTCF) instrument for nursing home residents to identify factors related to older people’s health that are significantly associated with the development of malnutrition. MethodsThis study analyzes data collected in the period 2019-2023 from nursing home residents, 65 or older, with a follow-up period of 1 year. After applying the GLIM criteria to the available interRAI LTCF data, a cross-sectional sample a longitudinal sample were analyzed by means of bivariate analysis. Factors included in the bivariate analysis were based in previous studies and expert opinion. Unadjusted and adjusted regression models were built to explore associations between several potential risk factors and nutritional status. ResultsThe sample consisted of 5598 older people with a mean age of 83.98 ± 7.30 years old and 71.2 % being female. Most people needed extensive assistance with activities of daily living (70.9%) and had at least a mild cognitive impairment (63.9%). According to the GLIM definition using the interRAI items, 8.43% of the residents were malnourished and 4.67% of the residents became malnourished over the period of 1 year. The final adjusted logistic regression yielded significant odds ratios for seven determinants: age (O.R. 1.03; C.I.: 1.01;1.04), depressive symptoms (O.R.: 1.32; 1.01; 1.73), assistance needed for walking (O.R. 1.49; C.I.: 1.13; 1.95), wandering behavior (O.R. 1.16; C.I.: 1.01; 1.33), falls (O.R. 1.17; C.I.: 1.02; 1.35), visual impairment (O.R. 1.22; C.I.: 1.05; 1.42) and diabetes (protective factor - O.R.: 0.67; C.I.: 0.46; 0.98). ConclusionsThe study showed the main risk factor for malnourishment in nursing home residents, such as age, depressions, assistance for walking, wandering and visual impairment. These significant factors can be used to identify people at risk of malnourishment. Periodically screening residents with the interRAI LTCF can help identify malnourished residents or residents at risk of malnourishment.

Health Education : Stunting Prevention in Nagari Api-Api, West Sumatra

Nagari Api-Api Pasar Baru, Bayang, Pesisir Selatan, West Sumatra is one of the areas that still faces major challenges related to stunting. Stunting is characterized by impaired growth and development in children, caused by insufficient nutrition, frequent infections, and a lack of psychosocial stimulation. Globally, 149.2 million children under the age of five (22.0 percent) are affected by this condition. Based on the results of a national survey of stunting sufferers in Pesisir Selatan for the 2023 period, there were 2,314 cases, 29.8 percent of the total number of children in the area, or an increase of 4.6 percent compared to 2022 which was 25.2 percent. Of that number, only 470 cases were children from underprivileged families and the rest were from children from well-off families. In terms of age, 795 cases were children aged 0-24 months and 1,519 cases were aged 24-59 months.Preparation of Extension Materials and Media Preparation of Extension Preparation of extension materials that include information about stunting, characteristics, causes, impacts, and prevention methods. Schmidt stated that stunting is a condition of malnutrition that occurs over a long period of time, resulting in impaired height growth in children. This makes them shorter compared to the standard height for their age (Aryastami, 2017).The results of the counseling activity were that participants understood and understood the causes and how to prevent stunting in children.

The effect of socioeconomic factors on malnutrition in Syrian children aged 0–6 years living in Turkey: a cross-sectional study

BackgroundThis study was conducted to examine the prevalence of malnutrition in Syrian immigrant children living in Turkey.MethodsThe study was carried out in the city of Mardin, which is one of the cities with a high Syrian immigrant population in Turkey. Height, body weight and BMI values were recorded to determine the malnutrition status of the children. Z-scores of children were calculated using the malnutrition assessment WHOAntro program.ResultsThe data show that 30.5% of Syrian children between the ages of 0 and 6 months are male, making up 55.8% of the total, and that 55.3% do not follow a regular breakfast schedule. The percentages of body weight for height, height for age, and BMI for age of Syrian children with a score between − 2 and + 2 SD Number were (89.3%), (74.3%), and (79.3%), respectively. Girls are more likely than boys to experience stunting and low body weight in the context of Syrian children (Stunting OR: 0.855(0.761–1.403), Underweight OR: 0.705(0.609-1,208)). Additionally, there is a link between levels of stunting and underweight and elements like the mother’s educational level and the family’s income. Contrary to the situation of adequate nutrition, it was discovered that the likelihood of stunting and low body weight in children increased by 0.809 and 1.039 times, respectively, when access to an adequate food supply was not available within the family (p < 0.05).Conclusions According to the results of the study, gender, family income, mother’s education level and access to food affected the severity of malnutrition in children. Migration is an imporatnt factor affecting children’s health. In this study malnutrition was found high im immigrant children. Programs should be developed to monitor the growth and development of disadvantaged children and to support their nutrition.

Low triiodothyronine is associated with high risk of malnutrition and poor functional status in subacute stroke patients

Background and AimsStroke patients may exhibit low thyroid hormone (TH) levels and disease-related malnutrition, both potentially affecting clinical status; their relationships remain unexplored. This study aimed to evaluate TH concentrations in subacute stroke patients and investigate the relationships between TH levels, nutritional risk, and functional status. Methods and ResultsEarly subacute stroke patients admitted to a rehabilitation unit were assessed using various nutritional screening tools (Geriatric Nutritional Risk Index-GNRI, Prognostic Nutritional Index-PNI, and Controlling Nutritional Status-CONUT score) and with the Global Leadership Initiative on Malnutrition (GLIM) criteria.Thyroid-Stimulating Hormone (TSH), free Tetraiodothyronine-Thyroxine (fT4) and free Triiodothyronine (fT3) levels were determined. Functional and cognitive status was evaluated using different scales. Associations between altered THs and nutritional status were examined through univariate/multivariate analyses and ROC analyses.Among 264 patients (age 72.0±10.5 yrs), significant correlations emerged between fT3 and nutritional risk and functional tests (mostly p<0.001). The prevalence of high nutritional risk determined by GNRI, PNI and CONUT increased from higher to lower fT3 tertiles. Lower fT3 levels were observed in patients at high nutritional risk and with GLIM-based malnutrition. fT3 exhibited reasonable predictive power for high nutritional risk (particularly PNI: AUC 0.769, 95%CI 0.702-0.836, p<0.001). Multivariate logistic regression identified nutritional risk (p<0.001) and time from stroke onset as predictors of low fT3 values. ConclusionAltered fT3 levels in early subacute stroke patients correlate with high nutritional risk and poor functional status. Low fT3 values upon admission for stroke rehabilitation may serve as a further parameter to be considered in patients at high nutritional risk.

An Automated Malnutrition Screening Tool Using Routinely Collected Data for Older Adults in Long-Term Care: Development and Internal Validation of AutoMal

ObjectiveTo develop and internally validate a malnutrition screening tool based on routinely collected data in the long-term care setting. DesignDiagnostic prediction model development and internal validation study. Setting and ParticipantsResidents (n = 539) from 10 long-term care facilities in Australia. MethodsCandidate variables identified through expert consultation were collected from routinely collected data in a convenience sample of long-term care facilities. Logistic regression using the Subjective Global Assessment as the reference standard was conducted on 500 samples derived using bootstrapping from the original sample. Candidate variables were selected if included in more than 95% of samples using backwards stepwise elimination. The final model was developed using logistic regression of selected variables. Internal validation was conducted using bootstrapping to calculate the optimism-adjusted performance. Overall discrimination was evaluated via receiver operator characteristic curve and calculation of the area under the curve. Youden's Index was used to identify the optimal threshold value for classifying malnutrition. Sensitivity and specificity were calculated. ResultsBody mass index and weight change % over 6 months were included in the automated malnutrition screening model (AutoMal), identified in 100% of bootstrapped samples. AutoMal demonstrated excellent discrimination of malnutrition, with area under the curve of 0.8378 (95% CI, 0.80–0.87). Youden's Index value was 0.37, resulting in sensitivity of 78% (95% CI, 71%–83%) and specificity of 77% (72%–81%). Optimism-corrected area under the curve was 0.8354. Conclusions and ImplicationsThe AutoMal demonstrates excellent ability to differentiate malnutrition status. It makes automated identification of malnutrition possible by using 2 variables commonly found in electronic health records.

Relationship between age, occupation, education, and parity with the chronic energy deficiency among pregnant women

Maternal and child health quality depends on maternal nutrition during pregnancy. Chronic energy deficiency (CED), a malnutrition condition common in pregnant women, increases the risk of the mother experiencing postpartum hemorrhage and the fetus experiencing intrauterine growth restriction (IUGR). The prevalence of CED risk among pregnant women in Sukabumi City, West Java, Indonesia is unstable and has not significantly decreased. This study aimed to determine the relationship between age, occupation, education, and parity with the risk of CED among pregnant women in Sukabumi City. An analytical observational study with a case-control approach using cluster sampling was conducted on 126 pregnant women with and without CED risk, respectively. The population for this study was pregnant women who checked at the primary health center in Sukabumi City in 2021. Data were collected from maternity health record and analyzed using Chi-square. The results showed that age had a significant relationship (p=0.000). In contrast, occupation (p=0.162), education (p=0.127), and parity (p=0.313) did not have a significant relationship with the risk of CED among pregnant women in Sukabumi City. Age was associated with the risk of CED among pregnant women in Sukabumi City.

Association between TMSE/MoCA and MIS/NAF in ESKD patients undergoing hemodialysis: a cross-sectional study

BackgroundBoth cognitive impairment and malnutrition are common in hemodialysis (HD) patients and are associated with increased hospitalization rates, infection, poor clinical outcomes, and mortality. The study investigated the association between cognitive and nutrition status among end-stage kidney disease (ESKD) patients undergoing hemodialysis.MethodsIn this cross-sectional study, we enrolled 115 patients with ESKD who underwent regular hemodialysis (HD). Data collection included the use of screening tools for mild cognitive impairment (MCI), specifically Thai Mental State Examination (TMSE) and Montreal Cognitive Assessment (MoCA). In addition, we collected data using nutritional screening tools including Malnutrition Inflammation Score (MIS) and Nutrition Alert Form (NAF). Our primary outcome was to demonstrate whether there was a relationship between TMSE/MoCA and MIS/NAF scores in this population. Secondary outcomes were a prevalence of MCI and malnutrition status in ESKD patients, an association between TMSE and MoCA with other surrogate nutritional markers, and factors affecting MCI in such patients.ResultsA total of 109 patients undergoing HD completed our protocol. Their mean age was 63.42 (± 15.82) years, and 51.38% were male. Mean TMSE and MoCA were 23.98 (± 5.06) points and 18.3 (± 6.40) points, respectively. The prevalence of TMSE ≤ 23 and MoCA ≤ 24 were 39.45% and 83.49%, respectively. TMSE had a statistically significant negative correlation with MIS (R2 = 0.16, p < 0.001) and NAF. MoCA also negatively correlated with MIS and NAF. The age, total educational year, the status of whether having a caregiver, serum albumin, serum phosphorus level, handgrip strength, and lean mass tissue were correlated with TMSE.ConclusionNutritional parameters, including MIS score, NAF score, serum albumin, lean tissue mass, and lean tissue index, significantly correlate with TMSE and MoCA.

IMPACT OF THE SIMBA KUAT PROGRAM (RAMBA SYNERGY IN THE FIELD OF SUPPORTING CLEAN AND HEALTHY LEISURE) ON HANDLING STUNTING

This paper seeks to analyze the impact of the Strong Synergy Program to Support Clean and Healthy Villages through the concept of "From Waste to Happy Community." Based on data that has been collected from posyandu activities in May 2024 in Keluang Village, Tungkal Ilir District, Banyuasin Regency, there are 8 toddlers experiencing stunting and malnutrition conditions out of 40 toddlers who attended the activity. The program is designed to reduce the amount of wood waste thrown away and reduce the negative impact caused, provide educational play tools that can improve the quality of children's learning and stimulation, help improve stunting conditions through better cognitive and motor stimulation, and provide economic opportunities for local artisans and drive the community's economy. This paper and the program can be a breakthrough in synergistic innovation, where it is a combination of environmental solutions with health and education interventions in Indonesia.

Nutritional status and related factors in inpatient pressure ulcer patients at Ho Chi Minh City Hospital Rehabilitation – Professional Diseases in 2023

A cross-sectional study was conducted at the Ho Chi Minh City Hospital Rehabilitation – Professional Diseases from February to May 2023 to describe nutritional status and related factors in inpatient pressure ulcer patients at Ho Chi Minh City Hospital Rehabilitation – Professional Diseases in 2023. The study focus on the prevalence of malnutrition and the relationship between malnutrition status based on SGA with demographic characteristics, pathology, and clinical laboratory parameters in inpatients with pressure ulcers at the hospital. The study results showed that the prevalence of malnutrition using the SGA method was 92.7%, while using anthropometric BMI was 15.6%. There was a statistically significant difference in the prevalence of malnutrition according to SGA with age groups, length of hospital stays, and stage of pressure ulcers (p &lt; 0.05). Malnutrition is a common issue among patients with pressure ulcers, thus early detection of nutritional status is crucial for developing intervention plans, counseling, and individualized nutritional care for patients.