Malnutrition associated with increased risk of frail mechanical falls among older people presenting to an emergency department

被引:33
|
作者
Vivanti, Angela P. [1 ]
McDonald, Cameron K. [2 ]
Palmer, Michelle A. [2 ]
Sinnott, Michael [1 ]
机构
[1] Princess Alexandra Hosp, Woolloongabba, Qld 4102, Australia
[2] Griffith Univ, Sch Publ Hlth, Gold Coast, Qld, Australia
关键词
accidental fall; aged; aged 80 and over; malnutrition; nutrition assessment; SUBJECTIVE GLOBAL ASSESSMENT; NUTRITIONAL ASSESSMENT; SCREENING TOOL; MORTALITY; SUPPLEMENTATION; PREVALENCE;
D O I
10.1111/j.1742-6723.2009.01223.x
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To identify associations between malnutrition falls risk and hospital admission among older people presenting to ED. Methods: A prospective convenience sample of patients, aged 60 years or more, presenting to an Australian tertiary teaching hospital ED were included in this cross-sectional study. Malnutrition Screening Tool and Subjective Global Assessment tool were administered to 126 non-consecutive participants. Participants were categorized as non-fallers, frail mechanical or active mechanical fallers. Self-reported falls in past 6 months and hospital admission were documented. Results: Participant age and sex (median age 74, interquartile range 65-82 years; male 59%, 74/126, 95% CI 50-67%) were representative of older people presenting to the ED. Malnutrition prevalence was 15% (19/126, 95% CI 9-21%). There was an increased risk of being assessed as malnourished when a frail mechanical faller relative to: a non-faller (relative risk [RR]: 1.5, 95% CI 1.0-2.3, P = 0.001), an active mechanical faller (RR: 3.1, 95% CI 1.0-10.9, Fisher's Exact test P = 0.02) or a non-faller and active mechanical faller combined (RR: 1.5, 95% CI 1.0-2.1, P = 0.001). Malnourished participants had an increased risk of self-reported falls over 6 months (RR: 1.5, 95% CI 1.0-2.5, P = 0.03). There was over five times the risk of hospital admission if malnourished than if well-nourished (RR: 5.3, 95% CI 1.4-20.0, Fisher's exact test P = 0.001). The Malnutrition Screening Tool captured 84% (16/19, 95% CI 78-92%) of participants assessed as malnourished by Subjective Global Assessment. Conclusions: Older people presenting to ED should be nutritionally screened. Malnutrition prevalence of 15% was documented and was associated with an increased risk of frail mechanical falls and hospital admission. The Malnutrition Screening Tool was a simple and practical screen for ED.
引用
收藏
页码:386 / 394
页数:9
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