Impact of Malnutrition on Hospitalization Outcomes for Older Adults Admitted for Sepsis |
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| Authors: | Ashraf Abugroun Asma Nayyar Manar Abdel-Rahman Pragnesh Patel |
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| Affiliation: | 1. Department of Medicine, Medical College of Wisconsin, WI, USA;2. Departments Internal Medicine, Marshall University Medical Center, WV, USA;4. Division of Geriatrics, Wayne State University, MI, USA;1. Faculty of Sport Sciences, Waseda University, Saitama, Japan;2. Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan;3. Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan;4. Department of Laboratory Medicine and Clinical Epidemiology for Prevention of Noncommunicable Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;5. Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan;6. Food Research Institute, National Agriculture and Food Research Organization, Tsukuba, Japan;7. Division of Preventive Medicine, Brigham and Women''s Hospital, Harvard Medical School, Boston, Mass;8. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass;9. Arnold School of Public Health, University of South Carolina, Columbia, SC;10. Niigata Association of Occupational Health, Niigata, Japan;11. Department of Health and Nutrition, University of Niigata Prefecture Faculty of Human Life Studies, Niigata, Japan;1. Department of Medicine, Oregon Health & Science University, Portland, OR;2. Department of Medicine, Division of Infectious Diseases, Oregon Health & Science University, Portland, OR;3. Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR;4. Department of Medicine, VA Portland Healthcare System; Portland, OR;1. Department of Cardiology, State University of New York Upstate Medical University, Syracuse;2. Department of Internal Medicine, State University of New York Upstate Medical University, Syracuse;1. Division of Cardiology, Ospedale di Cremona, Cremona, Italy;2. Division of Radiology, Ospedale di Cremona, Cremona, Italy;1. Department of Anesthesia, Queensland Children''s Hospital, Brisbane, Australia;2. Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Australia;3. Nursing and Midwifery Research Centre, The Royal Brisbane and Women''s Hospital, Brisbane, Australia;4. Patient Safety Enhancement Program, Division of Hospital Medicine, University of Michigan Health System, Ann Arbor;5. School of Nursing, Griffith University, Brisbane, Australia |
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| Abstract: | BackgroundMalnutrition is a major determinant of health outcomes among the older adult population. Our goal was to evaluate the impact of malnutrition on hospitalization outcomes for older adults who were admitted with a diagnosis of sepsis.MethodsThe National Inpatient Sample was queried for all patients who were admitted with a primary diagnosis of sepsis from January to December 2016. These patients were identified using the International Classification of Diseases, Tenth Revision (ICD-10) diagnosis code A419. Patients who were diagnosed with malnutrition were identified using ICD-10 codes E43, E440, E441, E45, and E46. Outcomes of hospitalization were modeled using logistic regression for binary outcomes and generalized linear models for continuous outcomes.ResultsOverall, a total of 808,030 patients were admitted for sepsis. Those diagnosed with malnutrition were 15.6% (126,335) of the total. The mean age (standard error of the mean) was 78 years (0.03). On multivariate analysis, malnutrition correlated with increased odds for mortality: adjusted OR (aOR) 1.20; 95% confidence interval [CI], 1.15-1.26; P < .001; septic shock: aOR 1.50; 95% CI, 1.44-1.57; P < .001; and intubation: aOR 1.45; 95% CI, 1.38-1.52; P < .001. It was also associated with higher odds for acute kidney injury and stroke. Malnutrition correlated with a 53% increase in the length of stay, with mean ratio 1.53; 95% CI, 1.51-1.56; P < .01; and a 54% increase in cost, with mean cost ratio 1.54; 95% CI, 1.51-1.58; P < .001.ConclusionAmong the geriatric population diagnosed with sepsis, malnutrition is an independent predictor for poor hospitalization outcomes. |
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| Keywords: | Geriatrics Malnutrition National Inpatient Sample Sepsis |
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