Ramdinpuia, - (2009) Nutritional assessment of elderly patients with acute medical illness presenting to a tertiary care hospital in south India: A case control study. Masters thesis, Christian Medical College, Vellore.
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Abstract
OBJECTIVES: To evaluate the nutritional status of elderly patients afflicted with acute medical illness and to ascertain if there is a correlation between malnutrition and acute medical illness among the elderly. Methods: 50 elderly patients of age 60 years or more presenting with acute medical illnesses, with onset of illness within 7 days were enrolled into the study and compared with 50 community dwelling elderly controls. The evaluation included clinical and laboratory evaluation of their nutritional status. Nutritional status was assessed using the mini nutritional assessment scoring system and anthropometric data like weight, height and mid arm circumference. Patients were followed up till they were discharged. The associations between malnutrition and acute medical illnesses were analyzed using the SPSS version 16 for windows to identify which factors were risk factors for acute medical illnesses among the elderly patients. RESULTS: 50 subjects were enrolled during the 8 months from January 2008 to August 2008. 24 % of the elderly patients with acute medical illnesses (cases) were malnourished compared to 2 % among the community dwelling elderly people (controls), as assessed by the mini nutritional assessment. 14% of the cases and 2 % of the controls were found to be at risk for malnutrition. The mean age among the cases was 69 ± 6.8 years, and the mean age among the controls was 65.5 ± 5.4 years. Cases were 4.5 times more likely (95% CI = 1.6-12.5) to have be malnourished (mini nutritional assessment - malnutrition indicator score of less than 17) as compared to the controls. The cases were also 7.5 times more likely (95% CI = 1.5-52.3) to be at risk for malnutrition (Mini Nutritional Assessment - Screening score of less than 12) as compared to the controls. The elderly patients with acute medical illnesses were 5.3 times more likely (95% CI = 1.1-25.8) to have mid arm circumference of less than 12 centimeters, and 65 times more likely (95% CI = 8.3-508.6) to have low serum albumin of less than 3.5 mg% as compared to the controls. The cases also had more co-morbidities (p < 0.001) and were on more number of drugs (p < 0.001) and also on more number of different types of drugs (mean numbers of drugs taken: 4.7 ± 1.6 by cases, 1 ± 1.7 by controls. p < 0.001), as compared to the controls. Infection was the commonest reason for admission among the cases. Cases with a low Mini Nutritional Assessment - Screening score had a poorer outcome in terms of discharge status (p 0.002) than cases with normal score. There was no correlation between individual anthropometric measurements and serum albumin to outcome among the cases. CONCLUSION: Malnutrition, as assessed by Mini Nutritional Assessment, mid arm circumference, and serum albumin is strongly associated with acute medical illness among the elderly. Polypharmacy and having more co morbidities were also associated with acute medical illness among the elderly. Malnutrition, as assessed by Mini Nutritional Assessment is also associated with poorer outcome among elderly patients admitted with acute medical illness.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Nutritional assessment ; elderly patients ; acute medical illness ; tertiary care hospital ; south India ; case control study. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Punitha K |
| Date Deposited: | 16 Jun 2018 03:43 |
| Last Modified: | 16 Jun 2018 03:43 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8517 |
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