scholarly journals Nutrition status and functional prognosis among elderly patients with distal radius fracture: a retrospective cohort study

2020 ◽  
Author(s):  
Takako Nagai ◽  
Koji Tanimoto ◽  
Yoshiaki Tomizuka ◽  
Hiroshi Uei ◽  
Masahiro Nagaoka
Keyword(s):  
Regression Analysis ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Distal Radius ◽  
Risk Index ◽  
The Elderly ◽  
Nutrition Status ◽  
Mineral Density ◽  
Poor Prognostic Factor ◽  
Nutritional Risk Index

Abstract Background : Distal radius fractures (DRF) are common in the elderly and are typical of hand fractures during falls. Malnutrition has also been identified as a poor prognostic factor in elderly patients with fractures. However, the relationship between nutritional status and subsequent falls and functional prognosis for DRF in the elderly is not clear. The aim of the present study was to investigate the association between nutritional status and functional prognosis in elderly patients with DRF. Methods : Study participants included 229 outpatients who required surgical treatment for DRF. The patients’ clinical information, including age, sex, body mass index, bone mineral density, Geriatric Nutritional Risk Index (GNRI), total number of drugs being treated with on admission, use of drugs for osteoporosis, comorbidity severity, the Barthel Index (BI), presence of subsequent falls, fracture type, postoperative follow-up period, and Mayo wrist score was reviewed. Subjects were further divided into two groups according to their GNRI: the malnutrition group and the normal group. Propensity score matching was used to confirm factors affecting the BI and subsequent falls. Results: Thirty-one patients (13.5%) presented with malnutrition before surgery for DRF. According to multiple liner regression analysis, the GNRI positively affected the efficiency of the BI (β = 0.392, 95% confidence interval [CI], 0.001 to 0.351, p = 0.039). Furthermore, on logistic regression analysis, subsequent falls were associated with serum albumin levels (odds ratio = 0.033, 95% CI, 0.002 to 0.477, p = 0.012). Conclusion : Malnutrition impaired improvement of activities of daily living (ADL) and increased the incidence of subsequent falls. Improvement of nutritional status before DRF surgery may further improve ADL and prevent falls.

scholarly journals Nutrition status and functional prognosis among elderly patients with distal radius fracture: a retrospective cohort study

2020 ◽  
Author(s):  
Takako Nagai ◽  
Koji Tanimoto ◽  
Yoshiaki Tomizuka ◽  
Hiroshi Uei ◽  
Masahiro Nagaoka
Keyword(s):  
Regression Analysis ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Distal Radius ◽  
Risk Index ◽  
The Elderly ◽  
Nutrition Status ◽  
Mineral Density ◽  
Poor Prognostic Factor ◽  
Nutritional Risk Index

Abstract Background: Distal radius fractures (DRF) are common in the elderly and are typically caused falls. Malnutrition has also been identified as a poor prognostic factor in elderly patients with fractures. However, the relationship between nutritional status and subsequent falls and functional prognosis for DRF in the elderly is not clear. The aim of the present study was to investigate the association between nutritional status and functional prognosis in elderly patients with DRF. Methods: Study participants included 229 outpatients who required surgical treatment for DRF. The patients’ clinical information, including age, sex, body mass index, bone mineral density, Geriatric Nutritional Risk Index (GNRI), total number of drugs being treated with on admission, use of drugs for osteoporosis, comorbidity severity, the Barthel Index (BI), presence of subsequent falls, fracture type, postoperative follow-up period, and Mayo wrist score was reviewed. Subjects were further divided into two groups according to their GNRI: the malnutrition group and the normal group. Propensity score matching was used to confirm factors affecting the BI and subsequent falls. Results: Thirty-one patients (13.5%) presented with malnutrition before surgery for DRF. According to multiple liner regression analysis, the GNRI positively affected the efficiency of the BI (β = 0.392, 95% confidence interval [CI], 0.001 to 0.351, p = 0.039). Furthermore, on logistic regression analysis, subsequent falls were associated with serum albumin levels (odds ratio = 0.033, 95% CI, 0.002 to 0.477, p = 0.012). Conclusion: Malnutrition impaired improvement of activities of daily living (ADL) and increased the incidence of subsequent falls. Improvement of nutritional status before DRF surgery may further improve ADL and prevent falls.

scholarly journals Nutrition status and functional prognosis among elderly patients with distal radius fracture: a retrospective cohort study

2020 ◽  
Author(s):  
takako nagai ◽  
Koji Tanimoto ◽  
Yoshiaki Tomizuka ◽  
Hiroshi Uei ◽  
Masahiro Nagaoka
Keyword(s):  
Regression Analysis ◽  
Confidence Interval ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Distal Radius ◽  
The Elderly ◽  
Nutrition Status ◽  
Mineral Density ◽  
Poor Prognostic Factor ◽  
Nutritional Risk Index

Abstract Background Distal radius fractures (DRF) are common in the elderly and are typical of hand fractures during falls. Malnutrition has also been identified as a poor prognostic factor in elderly patients with fractures. However, the relationship between nutritional status and subsequent falls and functional prognosis in the elderly DRF is not clear. The aim of the present study was to investigate the association between nutritional status and functional prognosis in patients with elderly DRF. Methods Study participants included 229 outpatients who required surgical treatment with DRF. The patients’ clinical information, including age, sex, body mass index, bone mineral density, Geriatric Nutritional Risk Index (GNRI), total number of drugs being treated with on admission, use of drugs for osteoporosis, comorbidity severity, Barthel Index(BI), presence of subsequent falls, fracture type, postoperative follow-up period, and Mayo wrist score was reviewed. The subjects were further divided into two groups according to their GNRI: the malnutrition group and the normal group. Propensity score matching was used to confirm the factor affecting BI and subsequent fall. Results Thirty-one patients (13.5%) were malnutrition before surgery for DRF. According to the multiple liner regression analysis, GNRI positively affected BI efficiency (β=0.392, 95% confidence interval, 0.001 to 0.351, p=0.039). Furthermore, on logistic regression analysis, subsequent fall was correlated with the serum albumin (odds ratio=0.033, 95% confidence interval,0.002 to 0.477, p=0.012). Conclusion Malnutrition impaired the improvement of the activity of daily living (ADL) and increased the incidence of subsequent fall. Improvement of nutritional status before DRF surgery may further improve ADL and prevent falls.

scholarly journals Association among Geriatric Nutrition Risk Index and functional prognosis in elderly patients with osteoporotic vertebral compression fractures: a retrospective cohort study

2020 ◽  
Author(s):  
Takako Nagai ◽  
Hiroshi Uei ◽  
Kazuyoshi Nakanishi
Keyword(s):  
Regression Analysis ◽  
Nutritional Status ◽  
Risk Index ◽  
Linear Regression Analysis ◽  
Compression Fracture ◽  
The Elderly ◽  
Vertebral Compression Fractures ◽  
Mineral Density ◽  
Nutritional Risk Index ◽  
The Relationship

Abstract Background Osteoporotic vertebral compression fracture (OVCF) is one of the most common fractures in the elderly and the number is increasing. In addition, nutritional status is associated with functional prognosis in the elderly. However, there are limited reports on the relationship between nutritional status and functional prognosis in OVCF. Furthermore, there are no reports that have examined the relationship between OVCF nutritional status and functional prognosis using geriatric nutritional risk index (GNRI) for nutritional assessment. The aim of this study was to investigate the association between nutritional status, activities of daily living (ADL), and fall after fracture in patients with OVCF. Methods The clinical information of 187 conservatively treated OVCF patients was retrospectively examined. This information included: age, sex, body mass index, total number of drugs used for treatment at admission, bone mineral density, use of drugs for osteoporosis, fracture type, comorbidity severity, nutritional status, Barthel Index (BI), and fall after OVCF. Subjects were divided into two groups according to their GNRI. Propensity score matching was used to confirm factors affecting BI and falls after OVCF. Results Sixty-eight patients (36.4%) presented with malnutrition at fracture. According to multiple linear regression analysis, GNRI positively affected BI gain (β = 0.283, 95% confidence interval [CI], -122.2 to -0.706, p = 0.001). Furthermore, on logistic regression analysis, fall after OVCF was associated with GNRI (odds ratio = 0.896, 95% CI, 0.832 to 0.964, p = 0.003). Conclusions Malnutrition in elderly OVCF patients decreases the acquisition of ADL and increases fall risk. Improvement of nutritional status during OVCF treatment may lead to improvement of ADL and prevention of falls.

scholarly journals Prognostic role of nutritional status in elderly patients hospitalized for COVID-19: a monocentric study

2020 ◽  
Vol 32 (12) ◽  
pp. 2695-2701 ◽  
Author(s):  
Guerino Recinella ◽  
Giovanni Marasco ◽  
Giovanni Serafini ◽  
Lorenzo Maestri ◽  
Giampaolo Bianchi ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Elderly Patients ◽  
Cox Regression ◽  
Risk Index ◽  
Univariate Analysis ◽  
Nutritional Risk ◽  
Hospital Death ◽  
Risk Category ◽  
Nutritional Risk Index

Abstract Background Symptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection incidence is higher in the elderly patients. Pre-existing geriatric conditions such as comorbidity and frailty seem related to worse hospital outcomes. Aims To assess the role of nutritional status as an independent prognostic factor for in-hospital death in elderly patients. Methods Consecutive elderly patients (age > 65 years) hospitalized for novel coronavirus disease (COVID-19) were enrolled. Demographics, laboratory and comorbidity data were collected. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI). Uni- and multivariate Cox regression analyses to evaluate predictors for in-hospital death were performed. Results One hundred and nine hospitalized elderly patients (54 male) were consecutively enrolled. At univariate analysis, age (HR 1.045 [CI 1.008–1.082]), cognitive impairment (HR 1.949 [CI 1.045–3.364]), C-reactive protein (HR 1.004 [CI 1.011–1.078]), lactate dehydrogenases (HR 1.003 [CI 1.001–1.004]) and GNRI moderate–severe risk category (HR 8.571 [CI 1.096–67.031]) were risk factors for in-hospital death, while albumin (HR 0.809 [CI 0.822–0.964]), PaO2/FiO2 ratio (HR 0.996 [CI 0.993–0.999]) and body mass index (HR 0.875 [CI 0.782–0.979]) were protective factors. Kaplan–Meier survival curves showed a significative higher survival in patients without GNRI moderate or severe risk category (p = 0.0013). At multivariate analysis, PaO2/FiO2 ratio (HR 0.993 [CI 0.987–0.999], p = 0.046) and GNRI moderate–severe risk category (HR 9.285 [1.183–72.879], p = 0.034) were independently associated with in-hospital death. Conclusion Nutritional status assessed by GNRI is a significative predictor of survival in elderly patients hospitalized for COVID-19. The association between GNRI and PaO2/FiO2 ratio is a good prognostic model these patients.

Relationship between Nutritional Scales and Prognosis in Elderly Patients after Acute Ischemic Stroke: Comparison of Controlling Nutritional Status Score and Geriatric Nutritional Risk Index

2021 ◽  
pp. 1-8
Author(s):  
Takayoshi Akimoto ◽  
Makoto Hara ◽  
Akihiko Morita ◽  
Shuichiro Uehara ◽  
Hideto Nakajima
Keyword(s):  
Ischemic Stroke ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Acute Ischemic Stroke ◽  
Poor Prognosis ◽  
Risk Index ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Nutritional Risk Index ◽  
Poor Outcomes

<b><i>Background/Aims:</i></b> Undernutrition is common in patients after acute ischemic stroke (AIS) and predicts poor clinical outcomes. We assessed the relationship between undernutrition and prognosis after AIS. <b><i>Methods:</i></b> We retrospectively assessed consecutively hospitalized AIS patients aged ≥65 years. A poor prognosis for patients after AIS was defined as a modified Rankin Scale (mRS) score of ≥3 at discharge. Nutritional status was evaluated based on the degree and risk of undernutrition as determined by the Controlling Nutritional Status (UND-CONUT) and Geriatric Nutritional Risk Index (UNR-GNRI) scores. <b><i>Results:</i></b> Among 218 patients (male, 62.8%; median age, 77 years), 81 had a poor prognosis. A significant correlation was found between UND-CONUT and UNR-GNRI scores (<i>p</i> &#x3c; 0.001, <i>r</i> = 0.433). Patients with a poor prognosis showed significant undernutrition based on UND-CONUT (<i>p</i> = 0.003) but not on UNR-GNRI (<i>p</i> = 0.218). Patients with undernutrition based on UND-CONUT showed poor outcomes: higher mRS scores at discharge, higher percentages of mRS scores of ≥2 and ≥3, and more complications associated with pneumonia. No significant differences were seen between cases with and without undernutrition risk based on UNR-GNRI. <b><i>Conclusion:</i></b> UND-CONUT appeared to be more useful than UNR-GNRI for predicting the prognosis of elderly patients with AIS at discharge.

Prognosis in Head and Neck Cancer: Importance of Nutritional and Biological Inflammatory Status

2021 ◽  
pp. 019459982110045
Author(s):  
Nicolas Saroul ◽  
Mathilde Puechmaille ◽  
Céline Lambert ◽  
Achraf Sayed Hassan ◽  
Julian Biau ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Prognostic Factors ◽  
Inflammatory Response ◽  
Nutritional Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Risk Index ◽  
Nutritional Risk ◽  
Inflammatory Status ◽  
Nutritional Risk Index

Objectives To determine the importance of nutritional status, social status, and inflammatory status in the prognosis of head and neck cancer. Study Design Single-center retrospective study of prospectively collected data. Setting Tertiary referral center. Methods Ninety-two consecutive patients newly diagnosed for cancer of the upper aerodigestive tract without metastases were assessed at time of diagnosis for several prognostic factors. Nutritional status was assessed by the nutritional risk index, social status by the EPICES score, and inflammatory status by the systemic inflammatory response index. The primary endpoint was overall survival. Results In multivariable analysis, the main prognostic factors were the TNM classification (hazard ratio [HR] = 3.34, P = .002, for stage T3-4), malnutrition as assessed by the nutritional risk index (HR = 3.64, P = .008, for severe malnutrition), and a systemic inflammatory response index score ≥1.6 (HR = 3.32, P = .02). Social deprivation was not a prognostic factor. Conclusion Prognosis in head and neck cancer is multifactorial; however, malnutrition and inflammation are important factors that are potentially reversible by early intervention.

scholarly journals Effects of 3-year GH replacement therapy on bone mineral density in younger and elderly adults with adult-onset GH deficiency

2012 ◽  
Vol 166 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Mariam Elbornsson ◽  
Galina Götherström ◽  
Celina Franco ◽  
Bengt-Åke Bengtsson ◽  
Gudmundur Johannsson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Elderly Patients ◽  
Bone Mineral ◽  
The Elderly ◽  
Marginal Effect ◽  
Adult Onset ◽  
Mineral Density ◽  
Gh Replacement ◽  
Femur Neck

ObjectiveLittle is known of the effects of long-term GH replacement on bone mineral content (BMC) and bone mineral density (BMD) in elderly GH-deficient (GHD) adults.Design/patients/methodsIn this prospective, single-center, open-label study, the effects of 3-year GH replacement were determined in 45 GHD patients >65 years and in 45 younger control GHD patients with a mean age of 39.5 (s.e.m.1.1) years. All patients had adult-onset disease and both groups were comparable in terms of number of anterior pituitary hormonal deficiencies, gender, body mass index, and waist:hip ratio.ResultsThe mean maintenance dose of GH was 0.24 (0.02) mg/day in the elderly patients and 0.33 (0.02) mg/day in the younger GHD patients (P<0.01). The 3 years of GH replacement induced a marginal effect on total body BMC and BMD, whereas femur neck and lumbar (L2–L4) spine BMC and BMD increased in both the elderly and the younger patients. The treatment response in femur neck BMC was less marked in the elderly patients (P<0.05 vs younger group). However, this difference disappeared after correction for the lower dose of GH in the elderly patients using an analysis of covariance. There were no between-group differences in responsiveness in BMC or BMD at other skeletal locations.ConclusionsThis study shows that GH replacement increases lumbar (L2–L4) spine and femur neck BMD and BMC in younger as well as elderly GHD patients. This supports the notion that long-term GH replacement is also useful in elderly GHD patients.

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