Clinical Impact of Nutritional Status and Energy Balance in Elderly Hospitalized Patients
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CLINICAL IMPACT OF NUTRITIONAL STATUS AND ENERGY BALANCE IN ELDERLY HOSPITALIZED PATIENTS S. ALLEPAERTS1, F. BUCKINX2, O. BRUYÈRE2,3,4, JY. REGINSTER2,4,5, N. PAQUOT6, S. GILLAIN1 1. Geriatric Department, CHU of Liège, Liège, Belgium; 2. Division of Public health, Epidemiology and health Economics, University of Liège, Liège, Belgium; 3. Department of Motricity Sciences, University of Liège, Liège, Belgium; 4. WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium; 5. Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia; 6. Department of Diabetes, nutrition and metabolic diseases, CHU of Liège, Belgium. Corresponding author: Sophie Allepaerts, University of Liège, Geriatric Department, CHU - NDB, Rue de Gaillarmont, 600, 4032 Chenee, Belgium, Tél : +32 43 67 93 93, E-mail : [email protected]
Abstract: Objectives: This study aimed 1) to assess the nutritional status of patients hospitalized in a geriatric ward using the recent Global Leadership Initiative on Malnutrition (GLIM) criteria, 2) to determine the balance between the energy intake (EI) with an enriched diet and the energy requirement (ER) using indirect calorimetry, and 3) to assess whether undernutrition is associated with 1-year outcome. Design: This is a prospective crosssectional study. Setting: This study was performed in a geriatric unit. Participants: Patients of this geriatric unit were eligible for the study if they agreed to participate and if they did not meet the exclusion criteria (presence of malignant tumour, uncontrolled heart or renal failure, thyroidal disease, uncontrolled sepsis, oedema of the lower limbs, wearing of a pacemaker, biological thyroid dysfunction and inability to perform walking tests). Measurements: Rest energy expenditure (REE) was measured by indirect calorimetry within the week of hospitalization. Total energy expenditure (TEE) was obtained by multiplying REE by a physical activity level coefficient and energy expenditure that was related to thermogenesis (i.e., 10% of the total amount of energy ingested over 24 h) was added. Food intake was measured over a 3-day period. Undernutrition was defined using MNA and the criteria of the GLIM leadership. Clinical outcomes included 1-year institutionalisation and mortality. Results: Seventy-nine patients (84.9 ± 5.3 years) were included. A total of 21 (26.6 %) patients were found undernourished. REE was 1088 ± 181kcal/day (17.8 ± 2.9 kcal/kg/day) and TEE was 1556 ± 258 kcal/day (25.4 ± 4.2 kcal/kg/day). Weight-adjusted REE and TEE were higher in undernourished patients compared to those well-nourished (19.8 ± 3.1 vs. 17.1 ± 2.6 kcal/day and 28.4±4.5 vs. 24.4±3.7 kcal/day) (p
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