This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Clinically Relevant Relationship

Raffaele Antonelli Incalzi, MD; Antonella Gemma, MD; Oliviero Capparella, MD; Luca Cipriani, MD; Francesco Landi, MD; PierUgo Carbonin, MD

Arch Intern Med. 1996;156(4):425-429.

Abstract
Background
Malnutrition is a common finding in the acute-care hospital.

Objectives
To assess the adequacy of nutritional intake to individual needs and the effects of the hospitalization on nutritional status, and to identify the reasons for inadequate energy intake.

Methods
A total of 286 patients with a mean (±SD) age of 79±6 years (range, 70 to 99 years), consecutively admitted to the geriatrics and internal medicine wards of an acute-care university hospital, underwent multidisciplinary assessment on admission and at discharge and daily dietary data collection. The needed, prescribed, and actual daily energy intake for each individual was measured. Nutritional depletion was diagnosed if midarm circumference decreased by 3.6% or more from admission to discharge.

Results
Nutritional depletion occurred in 27% of the patients and correlated with anorexia (86.4% vs 65.5% and 40% in patients whose midarm circumference was unchanged and increased, respectively; P<.001), Mini— Mental State Examination score (21.6±8.3 vs 23±6.9 and 26.5±3.6; P<.05), simplified premorbid Activities of Daily Living score (4.4±2.2 vs 5.1 ±1.8 and 5.0±1.8; P<.03), lymphocyte count (1.32 ±0.63 x 10⁹/L vs 1.62±0.88x10⁹/L and 1.47±0.50x10⁹/L; P<.03), serum albumin level (38±5 g/L vs 40±4 g/L and 39±8 g/L; P<.002), ratio of actual to needed energy intake (56.9%±22.1% vs 69.3%±30.4% and 60.0%±14.1%; P<.01), ratio of actual to prescribed energy intake (50.5%±16.9% vs 60.5%±20.5% and 65.5%±15.7%; P<.001). Patients who consumed less than 40% of the prescribed food complained of anorexia and masticatory inefficiency and were unsatisfied with quality and timing of meals compared with the other patients.

Conclusions
In-hospital starvation affects mainly patients with baseline nutritional, functional, and cognitive deficits and is strongly related to the inadequate energy intake.

(Arch Intern Med. 1996;156:425-429)

Author Affiliations
From the Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy (Drs Antonelli Incalzi, Cipriani, Landi, and Carbonin), and Teaching Nursing Home Cittadella della Carità, Taranto, Italy (Drs Gemma and Capparella).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Trajectories of Life-Space Mobility After Hospitalization
Brown et al.
ANN INTERN MED 2009;150:372-378.
ABSTRACT | FULL TEXT  

Nutrition Risk Factors in Older Coronary Artery Bypass Graft Patients
DiMaria-Ghalili
Nutr Clin Pract 2008;23:494-500.
ABSTRACT | FULL TEXT  

More Than Just not Being Alone: The Number, Nature, and Complementarity of Meal-Time Social Interactions Influence Food Intake in Hospitalized Elderly Patients
Paquet et al.
The Gerontologist 2008;48:603-611.
ABSTRACT | FULL TEXT  

Nutrition Screening vs Nutrition Assessment: How Do They Differ?
Charney
Nutr Clin Pract 2008;23:366-372.
ABSTRACT | FULL TEXT  

Medical record versus researcher measures of height and weight.
DiMaria-Ghalili
Biol Res Nurs 2006;8:15-23.
ABSTRACT  

Outcomes of Continuous Process Improvement of Nutritional Care Program Among Geriatric Units
Pepersack
J Gerontol A Biol Sci Med Sci 2005;60:787-792.
ABSTRACT | FULL TEXT  

First Autopsy Study of an Okinawan Centenarian: Absence of Many Age-Related Diseases
Bernstein et al.
J Gerontol A Biol Sci Med Sci 2004;59:1195-1199.
ABSTRACT | FULL TEXT  

Older Age and In-Hospital Development of Hypokalemia From Loop Diuretics: Results From a Multicenter Survey
Zuccala et al.
J Gerontol A Biol Sci Med Sci 2000;55:M232-M238.
ABSTRACT | FULL TEXT  

Protein-Energy Undernutrition Among Elderly Hospitalized Patients: A Prospective Study
Sullivan et al.
JAMA 1999;281:2013-2019.
ABSTRACT | FULL TEXT  

Prevalence and Clinical Outcome Associated with Preexisting Malnutrition in Acute Renal Failure: A Prospective Cohort Study
FIACCADORI et al.
J. Am. Soc. Nephrol. 1999;10:581-593.
ABSTRACT | FULL TEXT