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La Porta F, Valpiani G, Lullini G, Negro A, Pellicciari L, Bassi E, Caselli S, Pecoraro V, Govoni E. A novel multistep approach to standardize the reported risk factors for in-hospital falls: a proof-of-concept study. Front Public Health 2024; 12:1390185. [PMID: 38932769 PMCID: PMC11199548 DOI: 10.3389/fpubh.2024.1390185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Background Uncertainty and inconsistency in terminology regarding the risk factors (RFs) for in-hospital falls are present in the literature. Objective (1) To perform a literature review to identify the fall RFs among hospitalized adults; (2) to link the found RFs to the corresponding categories of international health classifications to reduce the heterogeneity of their definitions; (3) to perform a meta-analysis on the risk categories to identify the significant RFs; (4) to refine the final list of significant categories to avoid redundancies. Methods Four databases were investigated. We included observational studies assessing patients who had experienced in-hospital falls. Two independent reviewers performed the inclusion and extrapolation process and evaluated the methodological quality of the included studies. RFs were grouped into categories according to three health classifications (ICF, ICD-10, and ATC). Meta-analyses were performed to obtain an overall pooled odds ratio for each RF. Finally, protective RFs or redundant RFs across different classifications were excluded. Results Thirty-six articles were included in the meta-analysis. One thousand one hundred and eleven RFs were identified; 616 were linked to ICF classification, 450 to ICD-10, and 260 to ATC. The meta-analyses and subsequent refinement of the categories yielded 53 significant RFs. Overall, the initial number of RFs was reduced by about 21 times. Conclusion We identified 53 significant RF categories for in-hospital falls. These results provide proof of concept of the feasibility and validity of the proposed methodology. The list of significant RFs can be used as a template to build more accurate measurement instruments to predict in-hospital falls.
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Affiliation(s)
- Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Giorgia Valpiani
- Research and Innovation Unit, Biostatistics and Clinical Trial Area, University Hospital of Ferrara, Ferrara, Italy
| | - Giada Lullini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Antonella Negro
- Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Emilia-Romagna, Italy
| | | | - Erika Bassi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Serena Caselli
- Unità Operativa Complessa di Medicina Riabilitativa, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Valentina Pecoraro
- Department of Laboratory Medicine and Pathology, AUSL Modena, Modena, Italy
| | - Erika Govoni
- Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Emilia-Romagna, Italy
- Unità Organizzativa Riabilitazione Ospedaliera, Dipartimento Assistenziale Tecnico e Riabilitativo, Ausl Bologna, Bologna, Italy
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Eglseer D. Development and evaluation of a Massive Open Online Course (MOOC) for healthcare professionals on malnutrition in older adults. NURSE EDUCATION TODAY 2023; 123:105741. [PMID: 36746061 DOI: 10.1016/j.nedt.2023.105741] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/19/2022] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Education about malnutrition in older adults is often lacking in the curricula of healthcare professionals. Massive open online courses (MOOCs) are an innovative form of education that can potentially improve the knowledge of healthcare professionals. OBJECTIVES (1) to describe the development of a MOOC on malnutrition in older adults and (2) to evaluate the MOOC on the basis of knowledge gained. DESIGN The MOOC was developed by following a structured approach. For the evaluation of the MOOC, a cross-sectional descriptive study was conducted. PARTICIPANTS Overall, 1288 nurses, dietitians, medical doctors and other healthcare professionals participated in the evaluation study. METHODS After performing a comprehensive literature review, two dietitians specialised in geriatrics developed a summary of potentially important content of the MOOC. Nine European malnutrition experts from different professional areas were then asked to contribute their expertise. The specific MOOC content was developed based on the recent literature and evidence-based guidelines. For the evaluation of the MOOC, a questionnaire with 41 questions was developed. Results were analysed using descriptive statistics and chi-square tests. RESULTS The final MOOC consists of five modules with 15 learning videos and supplementary material. The percentage of persons with good malnutrition knowledge increased from 76.1 % to 89.9 % (p < 0.001), while the percentage of persons with fair or little malnutrition knowledge decreased (p < 0.001). The course significantly improved the participants' knowledge of specific malnutrition topics, namely, methods and instruments to determine the nutritional status of older people, interventions to improve oral intake, medical nutrition and multidisciplinary cooperation (p < 0.001). Overall, 91.5 % of the participants rated the quality of the course as very good or good. CONCLUSION MOOCs may be an effective tool that can be used to improve knowledge in healthcare professionals. This provides new opportunities for successful multidisciplinary malnutrition management in clinical practice.
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Affiliation(s)
- D Eglseer
- Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4; A, 8010 Graz, Austria.
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Smith ML, Ory MG. Multi-directional nature of falls among older adults: A rationale for prevention and management. Front Public Health 2023; 11:1117863. [PMID: 36895692 PMCID: PMC9989446 DOI: 10.3389/fpubh.2023.1117863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Affiliation(s)
- Matthew Lee Smith
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Marcia G Ory
- School of Public Health, Texas A&M University, College Station, TX, United States
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Heikkilä A, Lehtonen L, Junttila K. Fall rates by specialties and risk factors for falls in acute hospital: A retrospective study. J Clin Nurs 2022. [DOI: 10.1111/jocn.16594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 11/01/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Anniina Heikkilä
- University of Helsinki Helsinki Finland
- HUS Group Administration, Nursing, Helsinki University Hospital, University of Helsinki Helsinki Finland
| | - Lasse Lehtonen
- HUS Diagnostic Center Helsinki University Hospital, University of Helsinki Helsinki Finland
| | - Kristiina Junttila
- HUS Nursing Research Center Helsinki University Hospital, University of Helsinki Helsinki Finland
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Xu Q, Ou X, Li J. The risk of falls among the aging population: A systematic review and meta-analysis. Front Public Health 2022; 10:902599. [PMID: 36324472 PMCID: PMC9618649 DOI: 10.3389/fpubh.2022.902599] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/20/2022] [Indexed: 01/22/2023] Open
Abstract
Aim This study aims to clarify the risk factors for falls to prevent severe consequences in older adults. Methods We searched the PubMed, Web of Science, Embase, and Google Scholar databases using the terms "risk factors" OR "predicting factors" OR "predictor" AND "fall" OR "drop" to identify all relevant studies and compare their results. The study participants were divided into two groups, the "fall group" and the "control group", and differences in demographic characteristics, lifestyles, and comorbidities were compared. Results We included 34 articles in the analysis and analyzed 22 factors. Older age, lower education level, polypharmacy, malnutrition, living alone, living in an urban area, smoking, and alcohol consumption increased the risk of falls in the aging population. Additionally, comorbidities such as cardiac disease, hypertension, diabetes, stroke, frailty, previous history of falls, depression, Parkinson's disease, and pain increased the risk of falls. Conclusion Demographic characteristics, comorbidities, and lifestyle factors can influence the risk of falls and should be taken into consideration.
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Affiliation(s)
| | | | - Jinfeng Li
- Department of Geriatrics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
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Kupisz-Urbanska M, Marcinowska-Suchowierska E. Malnutrition in Older Adults—Effect on Falls and Fractures: A Narrative Review. Nutrients 2022; 14:nu14153123. [PMID: 35956299 PMCID: PMC9370498 DOI: 10.3390/nu14153123] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 07/26/2022] [Indexed: 12/10/2022] Open
Abstract
Malnutrition in older adults impacts health status, increased mortality, and morbidity. Malnutrition may increase the development of geriatric syndromes and contribute to a higher prevalence of falls and osteoporotic fractures that lead to loss of independence and an increased rate of institutionalization. The role of malnutrition in the pathogenesis of other geriatric syndromes seems to be well established. However, the data concerning nutritional interventions are confounding. Moreover, long-term undernutrition seems to be one of the factors that strongly influences the efficacy of interventions. This review outlines the current literature on this topic, and aims to guide physicians to make proper decisions to prevent the vicious cycle of falls, fractures, and their negative outcomes in patients with malnutrition.
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Affiliation(s)
- Malgorzata Kupisz-Urbanska
- Department of Geriatrics, Centre of Postgraduate Medical Education, 02-673 Warsaw, Poland
- Correspondence:
| | - Ewa Marcinowska-Suchowierska
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, 02-673 Warsaw, Poland;
- Department of Geriatrics and Gerontology, School of Public Health, Medical Centre of Postgraduate Education, 02-673 Warsaw, Poland
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Bellanti F, lo Buglio A, Quiete S, Vendemiale G. Malnutrition in Hospitalized Old Patients: Screening and Diagnosis, Clinical Outcomes, and Management. Nutrients 2022; 14:nu14040910. [PMID: 35215559 PMCID: PMC8880030 DOI: 10.3390/nu14040910] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 02/05/2023] Open
Abstract
Malnutrition in hospitalized patients heavily affects several clinical outcomes. The prevalence of malnutrition increases with age, comorbidities, and intensity of care in up to 90% of old populations. However, malnutrition frequently remains underdiagnosed and undertreated in the hospital. Thus, an accurate screening to identify patients at risk of malnutrition or malnourishment is determinant to elaborate a personal nutritional intervention. Several definitions of malnutrition were proposed in the last years, affecting the real frequency of nutritional disorders and the timing of intervention. Diagnosis of malnutrition needs a complete nutritional assessment, which is often challenging to perform during a hospital stay. For this purpose, various screening tools were proposed, allowing patients to be stratified according to the risk of malnutrition. The present review aims to summarize the actual evidence in terms of diagnosis, association with clinical outcomes, and management of malnutrition in a hospital setting.
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Charlton K, Walton K, Brumerskyj K, Halcomb E, Hull A, Comerford T, do Rosario VA. Model of nutritional care in older adults: improving the identification and management of malnutrition using the Mini Nutritional Assessment-Short Form (MNA®-SF) in general practice. Aust J Prim Health 2021; 28:23-32. [PMID: 34911616 DOI: 10.1071/py21053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/25/2021] [Indexed: 11/23/2022]
Abstract
Despite clinical guidelines recommending routine nutrition screening, malnutrition in community-living older adults remains under-recognised. This study evaluated the uptake of a model of nutritional care in older adults designed to improve the identification and management of malnutrition. A pragmatic quasi-experimental study was conducted in eight general practices in regional New South Wales between January 2017 and June 2018. Study participants comprised GPs and practice nurses who participated in a training event on the identification and management of malnutrition and patients (aged >65 years) attending the practices recruited to the study. Nutritional screening was conducted using the Mini Nutritional Assessment-Short Form. The specific objectives of the study were to: (1) evaluate the effects of the intervention on knowledge, attitudes and practices of staff related to malnutrition screening using questionnaires and in-depth interviews; and (2) identify patients' experiences and outcome measures following malnutrition screening through self-completed surveys. Across the eight practices, 11 healthcare professionals completed in-depth interviews. Post-training knowledge surveys (n = 25) identified that knowledge increased in 96% of staff (P < 0.001). Fifty-five older adults who were screened (two malnourished, 10 'at risk of malnutrition') reported an increased awareness of risk factors for malnutrition. This study provides proof-of-concept that a model of care that includes routine malnutrition screening and accompanying pathways for management is acceptable to general practice staff and has promising effects on patient outcomes. However, the low number of patients screened suggests that additional processes are required to improve feasibility (e.g. incorporation into Medicare-funded nurse-led consultations such as the 75+ Health Assessment).
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Affiliation(s)
- Karen Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia; and Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
| | - Karen Walton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia; and Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
| | | | - Elizabeth Halcomb
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; and School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Alycia Hull
- Grand Pacific Health, Wollongong, NSW 2500, Australia
| | - Teagan Comerford
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Vinicius Andre do Rosario
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia; and Corresponding author
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Sun B, Zhao Y, Lu W, Chen Y. The Relationship of Malnutrition With Cognitive Function in the Older Chinese Population: Evidence From the Chinese Longitudinal Healthy Longevity Survey Study. Front Aging Neurosci 2021; 13:766159. [PMID: 34880747 PMCID: PMC8645828 DOI: 10.3389/fnagi.2021.766159] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/13/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Objective: Few studies have explored the relationship between malnutrition measured by the Geriatric Nutritional Risk Index (GNRI) and cognitive performance. This study aimed to investigate the association of malnutrition with cognitive function in the Chinese population. Methods: It was a prospective longitudinal study and used three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2011–2012, 2014, and 2017–2018. Participants aged 60 years or older without mental illness and cerebrovascular diseases were eligible. The GNRI was used to assess nutritional status as follows: normal nutrition (a GNRI > 98), mild malnutrition (92 ≤ a GNRI ≤ 98), and moderate-to-severe malnutrition (a GNRI < 92). Cognitive performance was evaluated by the Mini-Mental State Examination (MMSE) scores. The relationship between the GNRI and cognitive function was analyzed using a linear mixed-effects model. Results: A total of 1,632 subjects were analyzed, including 741 males and 891 females. Of these, 65.0, 19.4, and 15.6% of subjects were at normal nutritional status, mild, and moderate-to-severe malnutrition, respectively. After adjusting for potential confounders, participants under mild and moderate-to-severe malnutrition status have a lower MMSE score [β (95% CI): –0.95 (–1.60, –0.25) and –1.39 (–2.21, –0.57), respectively], compared with those having normal nutrition. Also, there was a linear trend in the association of malnutrition risk with cognitive function in the total population [β (95% CI): –0.74 (–1.13, –0.35)]. However, a significant association of malnutrition with cognitive function was observed only among illiterate females aged above 90 years. Conclusion: This study suggested that there was a significant relationship between the GNRI and cognitive function in the Chinese elderly. Furthermore, subjects with more serious malnutrition have a worse cognitive function, especially in the oldest illiterate females. Clinicians should put more emphasis on assessing the nutritional and cognitive status of the elderly to timely intervene and prevent cognitive impairment.
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Affiliation(s)
- Boran Sun
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yihao Zhao
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
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Nawai A, Phongphanngam S, Khumrungsee M, Leveille SG. Factors associated with nutrition risk among community-dwelling older adults in Thailand. Geriatr Nurs 2021; 42:1048-1055. [PMID: 34256155 DOI: 10.1016/j.gerinurse.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022]
Abstract
This study was to investigate socio-demographic, chronic conditions and health factors associated with nutrition risk among Thai community-dwelling older adults. This was a cross-sectional study, involving 330 participants aged ≥ 60 years living in low-income suburban Chiang Mai, Northern Thailand. Of the 330 participants, 54.8% were at nutritional risk based on the Mini Nutritional Assessment. Multivariate analysis indicated factors significantly associated with nutritional risk were: aged ≥80 years (OR:8.59, 95% CI = 2.94-25.11), low income (OR: 2.35, 95% CI = 1.15-4.78), living alone (OR: 2.02, 95% CI = 0.20-0.78), moderate to severe pain (OR: 5.88, 95% CI = 2.30-15.02), dyslipidemia (OR: 5.12, 95% CI = 2.23-11.77), osteoarthritis (OR: 2.49, 95% CI = 1.14-5.48), poor physical performance (OR: 1.49, 95% CI = 1.70-3.15), and ≥1 fall in the previous year (OR: 2.22, 95% CI = 1.21-4.07). Results point to the need for multifactorial interventions to reduce risk for geriatric nutrition problems. Further studies are needed to determine effective solutions to the problem of malnutrition among older adults.
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Affiliation(s)
- Ampicha Nawai
- Boromarajonani College of Nursing, Chiang Mai, Thailand.
| | | | | | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
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Tanislav C, Kostev K. Factors associated with fracture after stroke and TIA: a long-term follow-up. Osteoporos Int 2020; 31:2395-2402. [PMID: 32647951 DOI: 10.1007/s00198-020-05535-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/01/2020] [Indexed: 01/20/2023]
Abstract
UNLABELLED We assessed the long-term incidence of fractures after stroke and TIA and analyzed associated factors. The fracture incidence increases with age and is higher in stroke than in TIA. Dementia is associated with fractures after both. Our results indicate tailored measures are necessary for preventing fractures after stroke or TIA. INTRODUCTION In the present study, we aimed to assess the long-term incidence of fractures and analyze associated factors after stroke or transient ischemic attack (TIA). METHODS The current cohort study included patients who had received an initial ischemic stroke or TIA diagnosis documented anonymously in the Disease Analyzer database (IQVIA) between 2000 and 2016 by physicians in 1262 general practices in Germany. Univariate Cox and multivariate regression models were carried out. RESULTS Three groups (stroke, TIA, no stroke/TIA), each with 12,265 individuals, were selected (mean age 67.3 years, 48.1% female). A fracture was diagnosed in 12.9% of stroke patients and in 11.4% of TIA patients. Among male stroke patients, 11.1% had a fracture (15.4% among female stroke patients). The hazard ratio (HR) for fractures after stroke was 1.26 (CI: 1.15-1.39) and for fractures after TIA, it was 1.14 (CI: 1.03-1.25). In female stroke patients, the HR for fractures was 1.32 (CI: 1.15-1.60), while in males, it was 1.20 (CI: 1.03-1.39). Among TIA patients, females had an elevated HR for fractures (HR: 1.21; CI: 1.06-1.37). In individuals aged ≥ 80 years, an increased risk for fractures was only detected among TIA patients (HR: 1.26; CI: 1.05-1.51). Dementia and non-opioid analgesic therapy were positively associated with fracture after both stroke and TIA. CONCLUSION Stroke was positively associated with fracture in patients < 80 years, while TIA was positively associated with fracture in patients ≥ 80 years and females. Dementia and analgesic therapy were also associated with fracture after either stroke or TIA.
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Affiliation(s)
- C Tanislav
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Wichernstrasse 40, 57074, Siegen, Germany.
| | - K Kostev
- Epidemiology, IQVIA, Frankfurt am Main, Germany
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Ishida Y, Maeda K, Nonogaki T, Shimizu A, Yamanaka Y, Matsuyama R, Kato R, Mori N. Malnutrition at Admission Predicts In-Hospital Falls in Hospitalized Older Adults. Nutrients 2020; 12:nu12020541. [PMID: 32093144 PMCID: PMC7071417 DOI: 10.3390/nu12020541] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 02/06/2023] Open
Abstract
Malnutrition leads to poor prognoses, including a predisposition to falls. Few studies have investigated the relationship between malnutrition and falls during hospitalization. This study aimed to determine malnutrition’s association with falls during hospitalization. A retrospective observational study was conducted. Patients aged ≥65 years that were admitted to and discharged from a university hospital between April 2018 and March 2019 were examined. Patients with independent basic activities of daily living were included. Diagnosis of malnutrition was based on the European Society for Clinical Nutrition and Metabolism (ESPEN) criteria at admission. Disease information such as the Charlson Comorbidity Index (CCI) and reasons for hospitalization were reviewed. Kaplan–Meier curve and multivariate Cox regression analyses were performed. Data from 6081 patients (mean age: 74.4 ± 6.1 years; males: 58.1%) were analyzed. The mean CCI was 2.3 ± 2.8 points. Malnutrition was detected in 668 (11.0%) and falls occurred in 55 (0.9%) patients. Malnourished patients experienced a higher fall rate than those without malnutrition (2.4% vs. 0.7%, log-rank test p < 0.001). In multivariate analysis, malnutrition had the highest hazard ratio for falls among covariates (hazard ratio 2.78, 95% confidence interval 1.51–5.00, p = 0.001). In conclusion, malnutrition at the time of admission to hospital predicts in-hospital falls.
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Affiliation(s)
- Yuria Ishida
- Department of Nutrition, Aichi Medical University Hospital, Nagakute 480-1195, Japan;
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan;
- Nutritional Therapy Support Center, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Correspondence: ; Tel.: +81-561-62-3311; Fax: +81-561-78-6364
| | - Tomoyuki Nonogaki
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan; (T.N.); (R.K.)
| | - Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8511, Japan;
| | - Yosuke Yamanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (Y.Y.); (R.M.)
| | - Remi Matsuyama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; (Y.Y.); (R.M.)
| | - Ryoko Kato
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan; (T.N.); (R.K.)
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan;
- Nutritional Therapy Support Center, Aichi Medical University Hospital, Nagakute 480-1195, Japan
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