Research Article
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Investigation of situation for development of infection, nutritional and length of hospital stay in elderly hospitalized in a palliative clinic

Year 2024, , 163 - 169, 30.08.2024
https://doi.org/10.30569/adiyamansaglik.1426866

Abstract

Aim: In our study, we aimed to evaluate patients' nutritional status, compare frequently used nutritional scales with each other and with the duration of hospitalization, and measure the effect of nutritional status on infection and mortality who are in the elderly.
Materials and Methods: Nutritional Risk Screening-2002, Mini Nutritional Assessment, and Geriatric Nutritional Risk Index were used. Patients were monitored for infection and mortality throughout the hospitalization period.
Results: The prevalence of malnutrition was found 98.6% with Mini Nutritional Assessment, 97.3% with Nutritional Risk Screening-2002, and 87.1% with Geriatric Nutritional Risk Index. A high correlation was found between the Geriatric Nutritional Risk Index and albumin, body mass index, arm, and calf circumference.
Conclusion: The malnutrition rate is quite high in patients who need palliative care. The Geriatric Nutritional Risk Index, compared to Nutritional Risk Screening-2002 and Mini Nutritional Assessment, is an effective and user-friendly scale that contains objective variables in bed-dependent patients for nutrition.

Ethical Statement

The present study was performed in line with the principles of the Declaration of Helsinki. Ethics committee approval for our study was received from Kutahya Dumlupinar University Faculty of Medicine Non-invasive Clinical Research Ethics Committee (dated 28.03.2018, decision No. 2018/5-4)

Supporting Institution

No person/organization is supporting this study financially.

Thanks

None.

References

  • Radbruch L, De Lima L, Knaul F, et al. Redefining palliative care: A new International Hospice and Palliative Care IHPC consensus-based definition. Journal of Pain and Symptom Management. 2020;60(4):754–764. https://doi.org/10.1016/j.jpainsymman.2020.04.027
  • Lödel S, Ostgathe C, Heckel M et al. Standard Operating Procedures (SOPs) for Palliative Care in German Comprehensive Cancer Centers - an evaluation of the implementation status. BMC Palliat Care 2020;19(1):1–9. https:// doi. org/ 10. 1186/ s12904- 020- 00565-6
  • Elia M. Defining, Recognizing, and Reporting Malnutrition. The international journal of lower extremity wounds. 2017;16(4):230-7.
  • Dent E, Wright ORL, Woo J, Hoogendijk EO. Malnutrition in older adults. Lancet. 2023; 401: 951-966.
  • Sungurtekin H, Sungurtekin U, Hanci V, Erdem E. Comparison of Two Nutrition Assessment Techniques in Hospitalized Patients. Nutrition. 2004;20(5):428-32.
  • Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional Risk Screening and Assessment. J Clin Med. 2019 Jul 20;8(7):1065. doi: 10.3390/jcm8071065. PMID: 31330781; PMCID: PMC6679209.
  • Drescher T, Singler K, Ulrich A, et al. Comparison of Two Malnutrition Risk Screening Methods (Mna and Nrs 2002) and Their Association with Markers of Protein Malnutrition in Geriatric Hospitalized Patients. European journal of clinical nutrition. 2010;64(8):887.
  • Cereda E, Vanotti A. The New Geriatric Nutritional Risk Index Is a Good Predictor of Muscle Dysfunction in Institutionalized Older Patients. Clinical Nutrition. 2007;26(1):78-83.
  • Jung EH, Lee SW, Kim YJ et al. Clinical outcomes of operating an acute palliative care unit at a comprehensive cancer center. JCO Oncol Pract 2022;18:e1661–e1671. https:// doi. org/ 10. 1200/ op. 22. 00163
  • Lödel S, Ostgathe Keller U. Nutritional Laboratory Markers in Malnutrition. J Clin Med. 2019;31;8(6):775. doi: 10.3390/jcm8060775. PMID: 31159248; PMCID: PMC6616535.
  • Turgut T, Varli, M. Nutrition in the Elderly in Palliative Care. Turkiye Clinicals Geriatrics-Special Topics. 2018; 4(1):72-78.
  • Uyar M. Nutrition in Palliative care ? Turkiye Clinicals Journal of Anesthesiology Reanimation Special Topics. 2017;10(1):45-8.
  • Lim SL, Ong KCB, Chan YH, et al. Malnutrition and Its Impact on Cost of Hospitalization, Length of Stay, Readmission and 3-Year Mortality. Clinical nutrition. 2012;31(3):345-50.
  • Yalçıntaş EB, Kızıltan G. Evaluaiton of Nutritional Status of Oncology Patients Receiving Palliative Care. Başkent Üniversitesi Sağlık Bilimleri Fakültesi Dergisi.2023; 8(1), 1-11.
  • Dowling L, Lynch DH, Batchek D, et.al. Nutrition interventions for body composition, physical function, cognition in hospitalized older adults: A systematic review of individuals 75 years and older. J Am Geriatr Soc. 2024 Feb 20. doi: 10.1111/jgs.18799. Epub ahead of print. PMID: 38376064.
  • Sorensen J, Kondrup J, Prokopowicz J, et al. Europe: An International, Multicentre Study to Implement Nutritional Risk Screening and Evaluate Clinical Outcome. Clinical nutrition. 2008;27(3):340-9.
  • Cereda E, Limonta D, Pusani C, Vanotti A. Assessing Elderly at Risk of Malnutrition: The New Geriatric Nutritional Risk Index Versus Nutritional Risk Index. Nutrition. 2006;22(6):680.
  • Korfalı G, Gündoğdu H, Aydıntuğ S, et al. Nutritional Risk of Hospitalized Patients in Turkey. Clinical nutrition. 2009;28(5):533-7.
  • Portero-McLellan KC, Staudt C, Silva F, et al. The Use of Calf Circumference Measurement as an Anthropometric Tool to Monitor Nutritional Status in Elderly Inpatients. The journal of nutrition, health & aging. 2010;14(4):266-70.
  • Bonnefoy M, Jauffret M, Kostka T, Jusot J. Usefulness of Calf Circumference Measurement in Assessing the Nutritional State of Hospitalized Elderly People. Gerontology. 2002;48(3):162-9.
  • Vellas B, Guigoz Y, Baumgartner M, et al. Relationships between Nutritional Markers and the Mini‐Nutritional Assessment in 155 Older Persons. Journal of the American Geriatrics Society. 2000;48(10):1300-9.
  • Durán Alert P, Milà Villarroel R, Formiga F, et al. Assessing Risk Screening Methods of Malnutrition in Geriatric Patients; Mini Nutritional Assessment (Mna) Versus Geriatric Nutritional Risk Index (Gnri). Nutricion hospitalaria. 2012;27(2).
  • Kyle ÚG, Kossovsky MP, Karsegard VL, Pichard C. Comparison of Tools for Nutritional Assessment and Screening at Hospital Admission: A Population Study. Clinical Nutrition. 2006;25(3):409-17.
  • Kuzu MA, Terzioğlu H, Genç V, et al. Preoperative Nutritional Risk Assessment in Predicting Postoperative Outcome in Patients Undergoing Major Surgery. World journal of surgery. 2006;30(3):378-90.
  • Robinson G, Goldstein M, Levine GM. Impact of Nutritional Status on Drg Length of Stay. Journal of Parenteral and Enteral Nutrition. 1987;11(1):49-51.
  • Chima CS, Barco K, Dewitt ML, et al. Relationship of Nutritional Status to Length of Stay, Hospital Costs, and Discharge Status of Patients Hospitalized in the Medicine Service. Journal of the American Dietetic Association. 1997;97(9):975-8.

Palyatif klinikte yatan yaşlılarda enfeksiyon gelişimi, beslenme durumu ve hastanede kalış süresinin araştırılması

Year 2024, , 163 - 169, 30.08.2024
https://doi.org/10.30569/adiyamansaglik.1426866

Abstract

Amaç: Çalışmamızda, palyatif bakım ünitesinde takip edilen yaşlı hastaların beslenme durumlarını değerlendirmeyi, sık kullanılan nutrisyon ölçeklerini birbirleriyle ve hastanede yatış süresiyle karşılaştırmayı, nutrisyonel durumun enfeksiyon ve mortalite üzerindeki etkisini ölçmeyi amaçladık.
Gereç ve Yöntem: Nutrisyonel Risk Taraması-2002, Mini Nutrisyonel Değerlendirme ve Geriatrik Nutrisyonel Risk İndeksi kullanıldı. Yatış süresi boyunca hastalar enfeksiyon ve mortalite açısından takip edildi.
Bulgular: Malnutrisyon sıklığı Mini Nutrisyonel Değerlendirme ile %98,6, Nutrisyonel Risk Taraması-2002 ile %97,3 ve Geriatrik Nutrisyonel Risk İndeksi ile %87,1 olarak bulundu. Geriatrik Nutrisyonel Risk İndeksi ile albumin, vücut kitle indeksi, kol çevresi ve baldır çevresi arasında yüksek düzeyde korelasyon mevcuttu.
Sonuç: Palyatif bakıma ihtiyaç duyan hastalarda malnütrisyon oranı oldukça yüksektir. Geriatrik Beslenme Risk İndeksi, Beslenme Risk Taraması-2002 ve Mini Nutrisyonel Değerlendirme ölçeği ile karşılaştırıldığında, yatağa bağımlı yaşlı hastalarda beslenme açısından objektif değişkenler içeren etkili ve kullanıcı dostu bir ölçektir.

Supporting Institution

yok

Thanks

yok

References

  • Radbruch L, De Lima L, Knaul F, et al. Redefining palliative care: A new International Hospice and Palliative Care IHPC consensus-based definition. Journal of Pain and Symptom Management. 2020;60(4):754–764. https://doi.org/10.1016/j.jpainsymman.2020.04.027
  • Lödel S, Ostgathe C, Heckel M et al. Standard Operating Procedures (SOPs) for Palliative Care in German Comprehensive Cancer Centers - an evaluation of the implementation status. BMC Palliat Care 2020;19(1):1–9. https:// doi. org/ 10. 1186/ s12904- 020- 00565-6
  • Elia M. Defining, Recognizing, and Reporting Malnutrition. The international journal of lower extremity wounds. 2017;16(4):230-7.
  • Dent E, Wright ORL, Woo J, Hoogendijk EO. Malnutrition in older adults. Lancet. 2023; 401: 951-966.
  • Sungurtekin H, Sungurtekin U, Hanci V, Erdem E. Comparison of Two Nutrition Assessment Techniques in Hospitalized Patients. Nutrition. 2004;20(5):428-32.
  • Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional Risk Screening and Assessment. J Clin Med. 2019 Jul 20;8(7):1065. doi: 10.3390/jcm8071065. PMID: 31330781; PMCID: PMC6679209.
  • Drescher T, Singler K, Ulrich A, et al. Comparison of Two Malnutrition Risk Screening Methods (Mna and Nrs 2002) and Their Association with Markers of Protein Malnutrition in Geriatric Hospitalized Patients. European journal of clinical nutrition. 2010;64(8):887.
  • Cereda E, Vanotti A. The New Geriatric Nutritional Risk Index Is a Good Predictor of Muscle Dysfunction in Institutionalized Older Patients. Clinical Nutrition. 2007;26(1):78-83.
  • Jung EH, Lee SW, Kim YJ et al. Clinical outcomes of operating an acute palliative care unit at a comprehensive cancer center. JCO Oncol Pract 2022;18:e1661–e1671. https:// doi. org/ 10. 1200/ op. 22. 00163
  • Lödel S, Ostgathe Keller U. Nutritional Laboratory Markers in Malnutrition. J Clin Med. 2019;31;8(6):775. doi: 10.3390/jcm8060775. PMID: 31159248; PMCID: PMC6616535.
  • Turgut T, Varli, M. Nutrition in the Elderly in Palliative Care. Turkiye Clinicals Geriatrics-Special Topics. 2018; 4(1):72-78.
  • Uyar M. Nutrition in Palliative care ? Turkiye Clinicals Journal of Anesthesiology Reanimation Special Topics. 2017;10(1):45-8.
  • Lim SL, Ong KCB, Chan YH, et al. Malnutrition and Its Impact on Cost of Hospitalization, Length of Stay, Readmission and 3-Year Mortality. Clinical nutrition. 2012;31(3):345-50.
  • Yalçıntaş EB, Kızıltan G. Evaluaiton of Nutritional Status of Oncology Patients Receiving Palliative Care. Başkent Üniversitesi Sağlık Bilimleri Fakültesi Dergisi.2023; 8(1), 1-11.
  • Dowling L, Lynch DH, Batchek D, et.al. Nutrition interventions for body composition, physical function, cognition in hospitalized older adults: A systematic review of individuals 75 years and older. J Am Geriatr Soc. 2024 Feb 20. doi: 10.1111/jgs.18799. Epub ahead of print. PMID: 38376064.
  • Sorensen J, Kondrup J, Prokopowicz J, et al. Europe: An International, Multicentre Study to Implement Nutritional Risk Screening and Evaluate Clinical Outcome. Clinical nutrition. 2008;27(3):340-9.
  • Cereda E, Limonta D, Pusani C, Vanotti A. Assessing Elderly at Risk of Malnutrition: The New Geriatric Nutritional Risk Index Versus Nutritional Risk Index. Nutrition. 2006;22(6):680.
  • Korfalı G, Gündoğdu H, Aydıntuğ S, et al. Nutritional Risk of Hospitalized Patients in Turkey. Clinical nutrition. 2009;28(5):533-7.
  • Portero-McLellan KC, Staudt C, Silva F, et al. The Use of Calf Circumference Measurement as an Anthropometric Tool to Monitor Nutritional Status in Elderly Inpatients. The journal of nutrition, health & aging. 2010;14(4):266-70.
  • Bonnefoy M, Jauffret M, Kostka T, Jusot J. Usefulness of Calf Circumference Measurement in Assessing the Nutritional State of Hospitalized Elderly People. Gerontology. 2002;48(3):162-9.
  • Vellas B, Guigoz Y, Baumgartner M, et al. Relationships between Nutritional Markers and the Mini‐Nutritional Assessment in 155 Older Persons. Journal of the American Geriatrics Society. 2000;48(10):1300-9.
  • Durán Alert P, Milà Villarroel R, Formiga F, et al. Assessing Risk Screening Methods of Malnutrition in Geriatric Patients; Mini Nutritional Assessment (Mna) Versus Geriatric Nutritional Risk Index (Gnri). Nutricion hospitalaria. 2012;27(2).
  • Kyle ÚG, Kossovsky MP, Karsegard VL, Pichard C. Comparison of Tools for Nutritional Assessment and Screening at Hospital Admission: A Population Study. Clinical Nutrition. 2006;25(3):409-17.
  • Kuzu MA, Terzioğlu H, Genç V, et al. Preoperative Nutritional Risk Assessment in Predicting Postoperative Outcome in Patients Undergoing Major Surgery. World journal of surgery. 2006;30(3):378-90.
  • Robinson G, Goldstein M, Levine GM. Impact of Nutritional Status on Drg Length of Stay. Journal of Parenteral and Enteral Nutrition. 1987;11(1):49-51.
  • Chima CS, Barco K, Dewitt ML, et al. Relationship of Nutritional Status to Length of Stay, Hospital Costs, and Discharge Status of Patients Hospitalized in the Medicine Service. Journal of the American Dietetic Association. 1997;97(9):975-8.
There are 26 citations in total.

Details

Primary Language English
Subjects Palliative Care
Journal Section Research Article
Authors

İsmail Balcıoğlu This is me 0000-0001-7345-9224

Yasemin Korkut Kurtoğlu 0000-0002-8293-8590

Early Pub Date August 19, 2024
Publication Date August 30, 2024
Submission Date January 28, 2024
Acceptance Date June 10, 2024
Published in Issue Year 2024

Cite

AMA Balcıoğlu İ, Korkut Kurtoğlu Y. Investigation of situation for development of infection, nutritional and length of hospital stay in elderly hospitalized in a palliative clinic. ADYÜ Sağlık Bilimleri Derg. August 2024;10(2):163-169. doi:10.30569/adiyamansaglik.1426866