Protein-energy malnutrition in elderly medical patients.
OBJECTIVE
To evaluate (1) the prevalence of protein-energy malnutrition in elderly patients; (2) the changes in nutritional status during the hospital stay; and (3) (main objective) the relationship between simple nutritional parameters and short-term in-hospital mortality.


METHODS
Prospective time series at admission and on the 15th day of hospitalization.


METHODS
Medical care unit in a teaching hospital.


METHODS
Consecutive sample of 324 hospitalized patients greater than or equal to 70 years (86.4% of eligible patients). Norms of measurements were obtained from a referred sample of healthy control subjects (26 males and 36 females).


METHODS
Mid-arm circumference, triceps skinfold thickness, serum albumin, prealbumin, and retinol-binding protein levels were measured in patients at admission and on the 15th day.


RESULTS
(1) Prevalence of PEM was 30% in male and 41% in female patients. (2) Both mid-arm circumference and serum albumin level decreased over the first 15 days of hospital stay (53 patients, paired t test, P less than 0.05). Triceps skinfold thickness did not change. (3) A step-wise discriminant-function analysis determined the utility of the parameters at admission as predictors of in-hospital mortality before the 15th day. Mid-arm circumference, triceps skinfold thickness, albumin, and prealbumin levels, as well as age, are predictors of in-hospital mortality, with 73% sensitivity, 69% specificity, and 70% of correctly classified patients of both sexes.


CONCLUSIONS
Parameters used are predictors for short-term in-hospital mortality of elderly patients hospitalized in an acute medical unit. The lean body mass is preferentially mobilized for energy during hospitalization.
Constans
T
T
Service de Gériatrie, Hôpital de l'Ermitage, Tours, France.
Bacq
Y
Y
Bréchot
J F
JF
Guilmot
J L
JL
Choutet
P
P
Lamisse
F
F
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D016002:Discriminant Analysis; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis; D012885:Skinfold Thickness
D012709:Serum Albumin