TITLE

Concurrent and predictive evaluation of malnutrition diagnostic measures in hip fracture inpatients: a diagnostic accuracy study

AUTHOR(S)
Bell, J J; Bauer, J D; Capra, S; Pulle, R C
PUB. DATE
March 2014
SOURCE
European Journal of Clinical Nutrition;Mar2014, Vol. 68 Issue 3, p358
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background/Objectives:Differences in malnutrition diagnostic measures impact malnutrition prevalence and outcomes data in hip fracture. This study investigated the concurrent and predictive validity of commonly reported malnutrition diagnostic measures in patients admitted to a metropolitan hospital acute hip fracture unit.Subjects/Methods:A prospective, consecutive level II diagnostic accuracy study (n=142; 8 exclusions) including the International Classification of Disease, 10th Revision, Australian Modification (ICD10-AM) protein-energy malnutrition criteria, a body mass index (BMI) <18.5 kg/m2, the Mini-Nutrition Assessment Short-Form (MNA-SF), pre-operative albumin and geriatrician individualised assessment.Results:Patients were predominantly elderly (median age 83.5, range 50-100 years), female (68%), multimorbid (median five comorbidities), with 15% 4-month mortality. Malnutrition prevalence was lowest when assessed by BMI (13%), followed by MNA-SF (27%), ICD10-AM (48%), albumin (53%) and geriatrician assessment (55%). Agreement between measures was highest between ICD10-AM and geriatrician assessment (κ=0.61) followed by ICD10-AM and MNA-SF measures (κ=0.34). ICD10-AM diagnosed malnutrition was the only measure associated with 48-h mobilisation (35.0 vs 55.3%; P=0.018). Reduced likelihood of home discharge was predicted by ICD-10-AM (20.6 vs 57.1%; P=0.001) and MNA-SF (18.8 vs 47.8%; P=0.035). Bivariate analysis demonstrated ICD10-AM (relative risk (RR)1.2; 1.05-1.42) and MNA-SF (RR1.2; 1.0-1.5) predicted 4-month mortality. When adjusted for age, usual place of residency, comorbidities and time to surgery only ICD-10AM criteria predicted mortality (odds ratio 3.59; 1.10-11.77). Albumin, BMI and geriatrician assessment demonstrated limited concurrent and predictive validity.Conclusions:Malnutrition prevalence in hip fracture varies substantially depending on the diagnostic measure applied. ICD-10AM criteria or the MNA-SF should be considered for the diagnosis of protein-energy malnutrition in frail, multi-morbid hip fracture inpatients.
ACCESSION #
94763019

 

Related Articles

  • Cachexia and protein-energy wasting in children with chronic kidney disease. Mak, Robert; Cheung, Wai; Zhan, Jian-Ying; Shen, Qian; Foster, Bethany // Pediatric Nephrology;Feb2012, Vol. 27 Issue 2, p173 

    Children with chronic kidney disease (CKD) are at risk for 'cachexia' or 'protein-energy wasting' (PEW). These terms describe a pathophysiologic process resulting in the loss of muscle, with or without loss of fat, and involving maladaptive responses, including anorexia and elevated metabolic...

  • Protein-energy wasting and uremic failure to thrive in children with chronic kidney disease: They are not small adults. Nourbakhsh, Noureddin; Rhee, Connie; Kalantar-Zadeh, Kamyar // Pediatric Nephrology;Dec2014, Vol. 29 Issue 12, p2249 

    Protein-energy wasting (PEW), a condition of decreased body protein and fat mass, is highly prevalent in patients with chronic kidney disease (CKD) and a potent predictor of mortality in this population. In adults with CKD, PEW has typically been defined on the basis of (1) deranged biochemical...

  • Prevalence of Fracture Risk Factors in Postmenopausal Women Enrolled in the POSSIBLE US Treatment Cohort. Yurgin, Nicole; Wade, Sally; Satram-Hoang, Sacha; Macarios, David; Hochberg, Marc // International Journal of Endocrinology;2013, p1 

    Subject- and physician-reported data from 4,429 postmenopausal women receiving osteoporosis treatment in the Prospective Observational Scientific Study Investigating Bone Loss Experience (POSSIBLE US) were used to assess the prevalence of risk factors (RFs) and on-study fracture. RFs assessed at...

  • Comparison between handgrip strength, subjective global assessment, anthropometry, and biochemical markers in assessing nutritional status of patients with Crohn's disease in clinical remission. Bin, Céres Maltz; Flores, Cristina; Álvares-da-Silva, Mário Reis; Francesconi, Carlos Fernando Magalhães; Bin, Céres Maltz; Alvares-da-Silva, Mário Reis; Francesconi, Carlos Fernando Magalhães // Digestive Diseases & Sciences;Jan2010, Vol. 55 Issue 1, p137 

    Introduction: Crohn's disease (CD) may lead to protein and calorie malnutrition (PCM) secondary to impaired digestive and absorptive functions of the small intestine and sometimes to the influence of diet taboos. The earlier the PCM is diagnosed, the higher are the odds of reversal....

  • Comparative Assessment of Fetal Malnutrition by Anthropometry and CAN Score. Soundarya, Mahalingam; Basavaprabhu, Achappa; Raghuveera, Kamila; Shivanagaraja, BSV // Iranian Journal of Pediatrics;Mar2012, Vol. 22 Issue 1, p70 

    Objectives: Fetal malnutrition (FM) implies soft tissue wasting at birth with significant postnatal consequences and morbidity, and is identified by clinical assessment (CAN score) and anthropometry. No previous studies have been done to study all these parameters and evolve a screening method....

  • Body mass index cut offs to define thinness in children and adolescents. Cameron, Noël // BMJ: British Medical Journal (International Edition);7/28/2007, Vol. 335 Issue 7612, p166 

    This editorial examines the use of the body mass index in predicting malnourishment. Less attention has been paid to the importance of assessing body mass index to monitor malnutrition and undernutrition than has been to predicting obesity. A study in this issue provides cut offs for body mass...

  • Body Mass Index in elderly people - do the reference ranges matter? Babiarczyk, B.; Turbiarz, A. // Progress in Health Sciences;2012, Vol. 2 Issue 1, p58 

    Introduction: Changes in body composition have important implications for the health status and functional efficiency of the elderly. There are many different methods used to diagnose malnutrition, with BMI being used most frequently. Purpose: The objective of this research was to analyse the...

  • Project set up to prevent malnutrition in later life. Keogh, Kat // Nursing Older People;Feb2014, Vol. 26 Issue 1, p7 

    The article offers information on the Malnutrition Prevention Project launched in England in January 2014. It states that the project will focus on people above 65 years of age with body mass index less than 8.5-25. It mentions that under the pilot program medical personnel will work with...

  • The great walk of China.  // Nursing Older People;Feb2014, Vol. 26 Issue 1, p7 

    The article reports that Matthew Hodson, nurse consultant at the Homerton University Hospital NHS Foundation Trust, will participate in a week-long trek along the Great Wall of China in April 2014 to raise funds for the British Lung Foundation.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics