TY - JOUR
T1 - Survival of cognitively impaired older hospitalized patients at risk of malnutrition
AU - Neelemaat, F.
AU - Bijland, L.R.
AU - Thijs, A.
AU - Seidell, J.C.
AU - van Bokhorst-de van der Schueren, M.A.E.
PY - 2012
Y1 - 2012
N2 - Introduction: In our society offering extra nutritional support is a standard for malnourished patients at admission to hospital. Whether cognitively impaired, older, hospitalized patients at risk of malnutrition would also benefit from this regimen is unknown. This study assesses their 3-months and 1-year survival. Prognostic characteristics predicting life expectancy are also studied. Methods: This prospective cohort included cognitively impaired, older, hospitalized patients at risk of malnutrition (group 1: dementia, 2: delirium and 3: combination dementia/delirium) newly admitted to an acute hospital and receiving usual nutritional care. Data on survival was completed until 1 year after patients' admission to the hospital. Possible prognostic characteristics predicting life expectancy data were collected. Results: A cohort of 116 cognitively impaired, older, hospitalized patients at risk of malnutrition is described. Forty-nine patients were described to have dementia, 48 delirium and 19 a combination of dementia and delirium. Mean age was 81.6 years (SD 8.3, range 60-99 years). Fifty-five patients (47.4%) died within 1 year after hospital admission, 36 of them (31%) died within 3 months after hospital admission. There were no significant differences in survival between the three groups (P = 0.672). Patients with a malignancy or vascular disease were more likely to die within 3 months after discharge. Multivariate analysis showed malignant neoplasm, vascular disease and age as prognostic factors for mortality. Conclusion: Almost half of a cohort of malnourished, cognitive impaired, older, hospitalized patients died within 1 year after hospital admission. Patients with a malignancy or vascular disease were more likely to die early after discharge. It could be defended that in these patients, extra-nutritional support should no longer be offered as a standard. © 2012 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
AB - Introduction: In our society offering extra nutritional support is a standard for malnourished patients at admission to hospital. Whether cognitively impaired, older, hospitalized patients at risk of malnutrition would also benefit from this regimen is unknown. This study assesses their 3-months and 1-year survival. Prognostic characteristics predicting life expectancy are also studied. Methods: This prospective cohort included cognitively impaired, older, hospitalized patients at risk of malnutrition (group 1: dementia, 2: delirium and 3: combination dementia/delirium) newly admitted to an acute hospital and receiving usual nutritional care. Data on survival was completed until 1 year after patients' admission to the hospital. Possible prognostic characteristics predicting life expectancy data were collected. Results: A cohort of 116 cognitively impaired, older, hospitalized patients at risk of malnutrition is described. Forty-nine patients were described to have dementia, 48 delirium and 19 a combination of dementia and delirium. Mean age was 81.6 years (SD 8.3, range 60-99 years). Fifty-five patients (47.4%) died within 1 year after hospital admission, 36 of them (31%) died within 3 months after hospital admission. There were no significant differences in survival between the three groups (P = 0.672). Patients with a malignancy or vascular disease were more likely to die within 3 months after discharge. Multivariate analysis showed malignant neoplasm, vascular disease and age as prognostic factors for mortality. Conclusion: Almost half of a cohort of malnourished, cognitive impaired, older, hospitalized patients died within 1 year after hospital admission. Patients with a malignancy or vascular disease were more likely to die early after discharge. It could be defended that in these patients, extra-nutritional support should no longer be offered as a standard. © 2012 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
U2 - 10.1016/j.eurger.2012.04.006
DO - 10.1016/j.eurger.2012.04.006
M3 - Article
SN - 1878-7649
VL - 3
SP - 330
EP - 335
JO - European Geriatric Medicine
JF - European Geriatric Medicine
ER -