title: Malnutrition: a highly predictive risk factor of short-term mortality in elderly presenting to the emergency department.
abstract: OBJECTIVE
  To identify independent risk factors of mortality among elderly patients in the 3 months after their visit (T3) to an emergency department (ED).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University hospital ED in an urban setting in France.
  
  
  METHODS
  One hundred seventy-three patients aged 75 and older were admitted to the ED over two weeks (18.7% of the 924 ED visits). Of these, 164 patients (94.8%) were included in our study, and 157 (95.7%) of them were followed three months after their ED visit.
  
  
  METHODS
  During the inclusion period (T0), a standardized questionnaire was used to collect data on socio-demographic and environmental characteristics, ED visit circumstances, medical conditions and geriatric assessment including functional and nutritional status. Three months after the ED visits (T3), patients or their caregivers were interviewed to collect data on vital status, and ED return or hospitalization.
  
  
  RESULTS
  Among the 157 patients followed at T3, 14.6% had died, 19.9% had repeated ED visits, and 63.1% had been hospitalized. The two independent predictive factors for mortality within the 3 months after ED visit were: malnutrition screened by the Mini Nutritional Assessment short-form (MNA-SF) (OR=20.2; 95% CI: 5.74-71.35; p<.001) and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) score (OR=1.1; 95% CI: 1.01-1.22; p=.024).
  
  
  CONCLUSIONS
  Malnutrition is the strongest independent risk factor predicting short-term mortality in elderly patients visiting the ED, and it was easily detected by MNA-SF and supported from the ED visit.
authors.affiliation: Laboratoire de Santé Publique, EA 3279, Faculté de Médecine, Université de La Méditerranée, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Gentile
authors.forename: O
authors.initials: O
authors.lastname: Lacroix
authors.forename: A C
authors.initials: AC
authors.lastname: Durand
authors.forename: E
authors.initials: E
authors.lastname: Cretel
authors.forename: M
authors.initials: M
authors.lastname: Alazia
authors.forename: R
authors.initials: R
authors.lastname: Sambuc
authors.forename: S
authors.initials: S
authors.lastname: Bonin-Guillaume
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D005602:France; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D009026:Mortality; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors
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