[Nutritional status, systemic inflammatory response syndrome and mortality in the elderly hospitalized patient].
In order to evaluate the relationship between systemic inflammatory response and mortality in the older hospitalized patient, we developed a prospective cohort study in which we evaluated a nutritional score (SGA), years of instruction, functional status, organic failure (Marshall), presence of sepsis, comorbidities (Charlson), cognitive state (MMSE), albumin, erythrocyte sedimentation rate and mortality. Fifty two patients were included, 19 men (36.5%) and 33 women (63.5%), mean age was 80 (Interquartile Range 12.5) years. 29 (55.8%) patients were well-nourished and 23 (44.2%) malnourished, 53.8% of patients developed sepsis at admission or during hospitalization. Total nosocomial mortality was 7.7 % (n = 4) and one-year mortality was 31.8% (n = 14). Comparative analyses showed older age (80 vs. 78; p = 0.012), less years of instruction (7 vs. 8; p = 0.027), lower MMST (14 vs. 27; p = 0.017), lower previous functional status (21 vs. 32; p < 0.0001), lower albumin (3 vs. 3.35; p = 0.014) and higher organic failure score at admission (3 vs. 1; p = 0.01) with more number of affected organs (2 vs. 1; p = 0.003) in malnourished patients compared to well nourished ones. Higher incidence of sepsis -at admission or during hospitalization- (73.9% vs. 37.9%; p = 0.01) and more severe stages of sepsis were also observed in malnourished patients. One-year mortality was significantly higher in malnourished (52.2% vs. 9.5%, log rank test = 0.002). In conclusion, malnourished patients presented greater systemic inflammatory response.
VI(ta) Cátedra de Medicina, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Argentina. ryxzamora@gmail.com
Rafael J
RJ
Zamora
Hernán
H
Chavin
Carlos J
CJ
Regazzoni
Ana A
AA
Pisarevsky
Enrique
E
Petrucci
Juan J
JJ
Poderoso
D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D044342:Malnutrition / Q000401:mortality*; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000502:physiology*; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000401:mortality*