PMID- 24755235
OWN - NLM
STAT- MEDLINE
DCOM- 20151208
LR  - 20150313
IS  - 1532-1983 (Electronic)
IS  - 0261-5614 (Linking)
VI  - 34
IP  - 2
DP  - 2015 Apr
TI  - Bedside measures of malnutrition and association with mortality in hospitalized 
      adults.
PG  - 252-6
LID - S0261-5614(14)00088-0 [pii]
LID - 10.1016/j.clnu.2014.03.013 [doi]
AB  - BACKGROUND & AIMS: The impact of malnutrition on the outcomes of hospitalized 
      adults in resource-limited settings such as sub-Saharan Africa (SSA) is not fully 
      described. We aimed to determine the association between malnutrition and 
      mortality in adults admitted to hospital in the resource-limited setting of 
      Southwestern Uganda. METHODS: We performed a cohort study of adults admitted to 
      the medical ward of Mbarara Regional Referral Hospital. Measures of nutritional 
      status included: 1) body mass index (BMI), 2) the mini-nutritional assessment 
      short form (MNA-sf), and 3) mid-upper arm circumference (MUAC). Subjects were 
      followed until death or 30 days from admission. We used proportional hazards 
      regression to assess associations between malnutrition and in-hospital and 30-day 
      mortality. RESULTS: We enrolled 318 subjects. The prevalence of malnutrition was 
      25-59% depending on the measure used. In-hospital and 30-day mortality were 18% 
      and 37% respectively. In the adjusted analysis, subjects with MNA-sf score 0-7 
      had a 2.7-fold higher risk of in-hospital mortality (95% CI: 1.3-5.9, p = 0.011) 
      than those with a score of 8-14, and subjects with malnutrition determined by 
      MUAC (<20 cm for males, and <19 cm for females) had a 1.8-fold higher risk of 
      in-hospital mortality (95% CI: 0.98-3.4, p = 0.06) than those normally nourished. 
      MNA-sf (HR 1.6, 95% CI: 1.02-2.6, p = 0.039) and MUAC (HR 1.6, 95% CI: 1.0-2.3, p 
      = 0.048) were independently predictive of 30-day mortality. BMI <18.5 was not 
      associated with in-hospital or 30-day mortality. CONCLUSIONS: Malnutrition was 
      common and simple measures of nutritional status predicted in-hospital and 30-day 
      mortality. Further research is needed to understand the pathophysiology of 
      malnutrition during acute illness and mitigate its effects.
CI  - Copyright (c) 2014 Elsevier Ltd and European Society for Clinical Nutrition and 
      Metabolism. All rights reserved.
FAU - Asiimwe, Stephen B
AU  - Asiimwe SB
AD  - Department of Internal Medicine, Mbarara University of Science and Technology, 
      Mbarara, Uganda; Mbarara Regional Referral Hospital, Mbarara, Uganda.
FAU - Muzoora, Conrad
AU  - Muzoora C
AD  - Department of Internal Medicine, Mbarara University of Science and Technology, 
      Mbarara, Uganda.
FAU - Wilson, L Anthony
AU  - Wilson LA
AD  - Department of Internal Medicine, Mbarara University of Science and Technology, 
      Mbarara, Uganda.
FAU - Moore, Christopher C
AU  - Moore CC
AD  - Division of Infectious Diseases and International Health, Department of Medicine, 
      University of Virginia, Charlottesville, VA, USA. Electronic address: 
      ccm5u@virginia.edu.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140405
PL  - England
TA  - Clin Nutr
JT  - Clinical nutrition (Edinburgh, Scotland)
JID - 8309603
SB  - IM
MH  - Adult
MH  - Body Mass Index
MH  - Cohort Studies
MH  - Female
MH  - *Hospital Mortality
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Malnutrition/epidemiology/*mortality
MH  - Middle Aged
MH  - *Nutrition Assessment
MH  - Prevalence
MH  - Regression Analysis
MH  - Uganda/epidemiology
OTO - NOTNLM
OT  - Acute illness
OT  - Adult
OT  - Africa
OT  - Hospitalized
OT  - Malnutrition
EDAT- 2014/04/24 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/04/24 06:00
PHST- 2013/12/04 00:00 [received]
PHST- 2014/03/03 00:00 [revised]
PHST- 2014/03/28 00:00 [accepted]
PHST- 2014/04/24 06:00 [entrez]
PHST- 2014/04/24 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - S0261-5614(14)00088-0 [pii]
AID - 10.1016/j.clnu.2014.03.013 [doi]
PST - ppublish
SO  - Clin Nutr. 2015 Apr;34(2):252-6. doi: 10.1016/j.clnu.2014.03.013. Epub 2014 Apr 
      5.