ArticleJournal of general internal medicine2002
Protein-energy undernutrition and life-threatening complications among the hospitalized elderly.
Article in Journal of general internal medicine, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 160 citations in OpenAlex.
- Usage of megestrol acetate in the treatment of anorexia-cachexia syndrome in the elderly.The journal of nutrition, health & aging · 2009Trial
- Prevention of unintentional weight loss in nursing home residents: a controlled trial of feeding assistance.Journal of the American Geriatrics Society · 2008Trial
- Global observational analysis of the Quality of Care Index (QCI) for protein-energy malnutrition from 1990 to 2021.Medicine · 2026Observational
- Geriatric nutrition risk index as an indicator of acute exacerbation and mortality risk in patients with idiopathic pulmonary fibrosis.BMC geriatrics · 2025Article
- The influence of high-fat diet and energy-restricted diet on hematopoietic stem cells: mechanisms and implications.Frontiers in immunology · 2025Review
- Socioeconomic status and older adult's experiences of weight loss: a qualitative secondary analysis.PloS one · 2025Article
- Observational
- Evaluation of Clinical Practice Guidelines for the Use of Supplementary Parenteral Nutrition in ICU Patients.International journal of general medicine · 2024Article
- The ability of the geriatric nutritional risk index to predict the risk of heart diseases in Korean adults: a Korean Genome and Epidemiology Study cohort.Frontiers in nutrition · 2023Article
- A change in temporal muscle thickness is correlated with past energy adequacy in bedridden older adults: a prospective cohort study.BMC geriatrics · 2021Article
- Evaluation of Oral Nutritional Supplementation in the Management of Frailty among the Elderly at Facilities of Community Care for the Elderly.Clinical nutrition research · 2021Article
- Nutrition Education on the Wards: A Self-Study Module for Improving Medical Student Knowledge of Nutrition Assessment and Interventions.MedEdPORTAL : the journal of teaching and learning resources · 2020Article
- Article
- Article
- Observational
- Malnutrition and related risk factors in older adults from different health-care settings: anPublic health nutrition · 2020Article
- Protein Intake Falls below 0.6 g•kg-1•d-1 in Healthy, Older Patients Admitted for Elective Hip or Knee Arthroplasty.The journal of nutrition, health & aging · 2019Article
- Assessment of Malnutrition in Community-dwelling Elderly People: Cooperation among General Practitioners and Public Health.Iranian journal of public health · 2018Article
- Preoperative hypoalbuminemia is associated with an increased risk for intra-abdominal septic complications after primary anastomosis for Crohn's disease.Gastroenterology report · 2017Article
- Poor Appetite and Dietary Intake in Community-Dwelling Older Adults.Journal of the American Geriatrics Society · 2017Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether elderly patients with protein-energy undernutrition at admission are at increased risk for subsequent life-threatening events after controlling for illness severity.
designProspective cohort study.
settingUniversity-affiliated Department of Veterans Affairs hospital. PATIENTS: Five hundred eighty-six nonterminal patients (mean age 74 +/- 6 [SD] years, 98% male, 86% white) with a length of stay of 3 days or more.
main outcome measuresLife-threatening complications.
resultsSubsequent to admission, 37 subjects (6.3%) experienced at least 1 life-threatening complication. All of the putative nutrition variables examined and many non-nutrition, illness severity measures were strongly correlated with the risk of a life-threatening complication by univariate analyses (P <.05 for all analyses). After controlling for illness severity, admission serum albumin, prealbumin, and cholesterol were no longer significantly correlated with the outcome. In contrast, weight loss (>5% within 6 months), body mass index, mid-arm circumference, and suprailiac skinfold thickness remained strong independent predictors. The adjusted relative risk of a life-threatening complication ranged from 2.9 (95% confidence interval [CI], 1.3 to 6.4) for a body mass index <22 kg/m2 to 7.1(95% CI, 2.0 to 25.7) for a suprailiac skinfold thickness in the lower tertile for the study population. The putative nutrition and illness severity variables were highly intercorrelated.
conclusionsThere is a complex interrelationship between nutritional status, illness severity, and clinical outcomes among the hospitalized elderly. The serum secretory proteins and cholesterol are correlated with other indicators of illness severity and adverse outcomes, but may not be good markers of nutritional risk. In contrast, weight loss, a low body mass index, and other indicators of lean and fat mass depletion appear to place the patient at increased risk for adverse outcomes independent of illness severity. Whether it is possible to reverse such established nutritional deficits and reduce complication risk in the acute care setting remains to be determined.
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