Dataset Information

Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

ABSTRACT: Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury.To identify modifiable risk factors associated with malnutrition in older patients.Prospective cross-sectional multicenter study.3 EDs in the South, Northeast, and Midwest.Non-critically ill, English-speaking adults aged ?65 years.Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor.In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%).Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults.

SUBMITTER: Burks CE

PROVIDER: S-EPMC5555801 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

Burks Collin E CE Jones Christopher W CW Braz Valerie A VA Swor Robert A RA Richmond Natalie L NL Hwang Kay S KS Hollowell Allison G AG Weaver Mark A MA Platts-Mills Timothy F TF

Journal of the American Geriatrics Society 20170321 8

<h4>Background</h4>Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury.<h4>Objective</h4>To identify modifiable risk factors associated with malnutrition in older patients.<h4>Design</h4>Prospective cross-sectional multicenter study.<h4>Setting</h4>3 EDs in the South, Northeast, and Midwest.<h4>Participants</h4>Non-critically ill, English-speaking adults aged ≥65 years.<h4>Measurements</h4>Random time block sampling was ...[more]

PMID: 28322438

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Project description:BackgroundUnscheduled emergency department return visits (EDRVs) are key indicators for monitoring the quality of emergency medical care. A high return rate implies that the medical services provided by the emergency department (ED) failed to achieve the expected results of accurate diagnosis and effective treatment. Older adults are more susceptible to diseases and comorbidities than younger adults, and they exhibit unique and complex clinical characteristics that increase the difficulty of clinical diagnosis and treatment. Older adults also use more emergency medical resources than people in other age groups. Many studies have reviewed the causes of EDRVs among general ED patients; however, few have focused on older adults, although this is the age group with the highest rate of EDRVs.ObjectiveThis aim of this study is to establish a model for predicting unscheduled EDRVs within a 72-hour period among patients aged 65 years and older. In addition, we aim to investigate the effects of the influencing factors on their unscheduled EDRVs.MethodsWe used stratified and randomized data from Taiwan's National Health Insurance Research Database and applied data mining techniques to construct a prediction model consisting of patient, disease, hospital, and physician characteristics. Records of ED visits by patients aged 65 years and older from 1996 to 2010 in the National Health Insurance Research Database were selected, and the final sample size was 49,252 records.ResultsThe decision tree of the prediction model achieved an acceptable overall accuracy of 76.80%. Economic status, chronic illness, and length of stay in the ED were the top three variables influencing unscheduled EDRVs. Those who stayed in the ED overnight or longer on their first visit were less likely to return. This study confirms the results of prior studies, which found that economically underprivileged older adults with chronic illness and comorbidities were more likely to return to the ED.ConclusionsMedical institutions can use our prediction model as a reference to improve medical management and clinical services by understanding the reasons for 72-hour unscheduled EDRVs in older adult patients. A possible solution is to create mechanisms that incorporate our prediction model and develop a support system with customized medical education for older patients and their family members before discharge. Meanwhile, a reasonably longer length of stay in the ED may help evaluate treatments and guide prognosis for older adult patients, and it may further reduce the rate of their unscheduled EDRVs.

Dataset Information

Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

Publications

Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

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