| Titre : | Prevalence and Prognosis Impact of Malnutrition in Elderly of a Moroccan Acute Medical Unit | | Type de document : | thèse | | Auteurs : | Myriam BIZRANE, Auteur | | Année de publication : | 2016 | | Langues : | Français (fre) | | Mots-clés : | Acute medical unit (AMU) Elderly Malnutrition Mini-nutritional assessment Mortality. | | Résumé : | Introduction: Our study aimed to identify the prevalence of malnutrition in elderly admitted to an AMU and to compare patients according to their nutritional status; then analyze the prognosis impact of malnutrition at 540 days follow-up.
Method: This was a prospective cohort studyconducted in the AMU of IbnSina University Hospital, Rabat, from June to September 2014, including patients aged of ≥65 years. Demographic, anthropometric and clinical characteristics, comorbid diseases and in-hospital evolution data were included. Survival status was evaluated in the hospital and at 540 days follow-up. For malnutrition we used MNA, and for the health and functional status, EuroQol-5D and ADL. We identified the factors associated with long-term mortality. Then, multivariable model incorporating conventional risk variables (Model1 and Model2) was calculated and its predictive performance assessed. Statistical analyses were carried out in SPSS Statistics and STATA 14.
Results: We included 95 patients. Mean age was 75±5.9 years; 64.2% were women. In-hospital and 540 days mortality were 16.8% and 46.3%. Median of ADL and EQ5D-Index before acute illness were 5.5 [3.5;6] and 0.29 [-0.17;0.81]. Prevalences of well-nourished, at risk of malnutrition and malnourished patients were 46.3%, 27.4%, and 26.3%. Compared to well-nourished patients, others had significantly higher mortality. Multivariate analyses showed that malnutrition was a strong independent predictor of long-term mortality. Model2 included; unmarried patients, lower Mean arterial pressure, lower EQ5D index andmalnourished patients. For increasing probability thresholds, the model2 had higher net benefit, suggesting its potentially higher clinical utility.
Conclusion: Malnutrition has a negative prognosis impact on the long-term survival status of elderly in an AMU. Therefore, its high clinical utility should be considered to guide nutrition interventions.
| | Numéro (Thèse ou Mémoire) : | M3722016 | | Président : | ABOUQAL.R | | Directeur : | BELAYACHI.J | | Juge : | MADANI.N | | Juge : | BARAKAT.A |
Prevalence and Prognosis Impact of Malnutrition in Elderly of a Moroccan Acute Medical Unit [thèse] / Myriam BIZRANE, Auteur . - 2016. Langues : Français ( fre) | Mots-clés : | Acute medical unit (AMU) Elderly Malnutrition Mini-nutritional assessment Mortality. | | Résumé : | Introduction: Our study aimed to identify the prevalence of malnutrition in elderly admitted to an AMU and to compare patients according to their nutritional status; then analyze the prognosis impact of malnutrition at 540 days follow-up.
Method: This was a prospective cohort studyconducted in the AMU of IbnSina University Hospital, Rabat, from June to September 2014, including patients aged of ≥65 years. Demographic, anthropometric and clinical characteristics, comorbid diseases and in-hospital evolution data were included. Survival status was evaluated in the hospital and at 540 days follow-up. For malnutrition we used MNA, and for the health and functional status, EuroQol-5D and ADL. We identified the factors associated with long-term mortality. Then, multivariable model incorporating conventional risk variables (Model1 and Model2) was calculated and its predictive performance assessed. Statistical analyses were carried out in SPSS Statistics and STATA 14.
Results: We included 95 patients. Mean age was 75±5.9 years; 64.2% were women. In-hospital and 540 days mortality were 16.8% and 46.3%. Median of ADL and EQ5D-Index before acute illness were 5.5 [3.5;6] and 0.29 [-0.17;0.81]. Prevalences of well-nourished, at risk of malnutrition and malnourished patients were 46.3%, 27.4%, and 26.3%. Compared to well-nourished patients, others had significantly higher mortality. Multivariate analyses showed that malnutrition was a strong independent predictor of long-term mortality. Model2 included; unmarried patients, lower Mean arterial pressure, lower EQ5D index andmalnourished patients. For increasing probability thresholds, the model2 had higher net benefit, suggesting its potentially higher clinical utility.
Conclusion: Malnutrition has a negative prognosis impact on the long-term survival status of elderly in an AMU. Therefore, its high clinical utility should be considered to guide nutrition interventions.
| | Numéro (Thèse ou Mémoire) : | M3722016 | | Président : | ABOUQAL.R | | Directeur : | BELAYACHI.J | | Juge : | MADANI.N | | Juge : | BARAKAT.A |
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