Disease-Related Malnutrition and Sarcopenia Predict Worse Outcome in Medical Inpatients: A Cohort Study

Nutrients

María José Cuevas¹  María D. Ballesteros-Pomar²  Lucía González-Roza²  María Pilar García-Pérez²  Luisa Mercedes Gajete-Martín²  Begoña Pintor-de-la-Maza²  Elena González-Arnáiz²  Isidoro Cano-Rodríguez²  Esther Fernández-Perez³  José Luis Mostaza-Fernández³  María Ascensión García-González³  Rocío de Prado-Espinosa³  Verónica González-Alonso³ 

[1] Departament of Biomedical Sciences, Institute of Biomedicine, University of León, Campus de Vegazana, 24071 León, Spain;Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain;Department of Internal Medicine, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava s/n, 24071 León, Spain;

关键词: disease-related malnutrition;    sarcopenia;    GLIM criteria;    EWGSOP2;    hand grip strength;    appendicular lean mass;   

DOI  :  10.3390/nu13092937

来源: DOAJ

【 摘 要 】

(1) Background: Both sarcopenia and disease-related malnutrition (DRM) are unfortunately underdiagnosed and undertreated in our Western hospitals, which could lead to worse clinical outcomes. Our objectives included to determine the impact of low muscle mass (MM) and strength, and also DRM and sarcopenia, on clinical outcomes (length of stay, death, readmissions at three months, and quality of life). (2) Methodology: Prospective cohort study in medical inpatients. On admission, MM and hand grip strength (HGS) were assessed. The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose DRM and EWGSOP2 for sarcopenia. Assessment was repeated after one week and at discharge. Quality of life (EuroQoL-5D), length of stay (LoS), readmissions and mortality are reported. (3) Results: Two hundred medical inpatients, median 76.0 years-old and 68% with high comorbidity. 27.5% met GLIM criteria and 33% sarcopenia on admission, increasing to 38.1% and 52.3% on discharge. Both DRM and sarcopenia were associated with worse QoL. 6.5% died and 32% readmission in 3 months. The odds ratio (OR) of mortality for DRM was 4.36 and for sarcopenia 8.16. Readmissions were significantly associated with sarcopenia (OR = 2.25) but not with DRM. A higher HGS, but not MM, was related to better QoL, less readmissions (OR = 0.947) and lower mortality (OR = 0.848) after adjusting for age, sex, and comorbidity. (4) Conclusions: In medical inpatients, mostly polymorbid, both DRM but specially sarcopenia are associated with poorer quality of life, more readmissions, and higher mortality. Low HGS proved to be a stronger predictor of worse outcomes than MM.

【 授权许可】

Unknown