Malnutrition in Hospitalized Adults With Cerebral Palsy

Abstract

Background: Malnutrition among hospitalized adults with cerebral palsy (CP) has not been extensively explored. We sought to identify impacts of malnutrition on clinical and resource outcomes among hospitalized adults with CP. Methods: This retrospective cohort study surveyed years 2016 and 2017 from the National Inpatient Sample database. Regression models evaluated mortality and resource utilization. Results: 154,219 adults with CP were hospitalized. Among them, 21,064/154,219 (13.5%) had malnutrition. Patients with and without malnutrition were similar in age (mean age ± SEM, 45.1 ± 0.30 vs 45.2 ± 0.18 years; P = .70). Patients with malnutrition were more likely male (12,175/21,604 [57.8%] vs 72,929/133,155 [54.8%], P < .01) and had higher comorbidity scores (Charlson comorbidity score ≥ 3; 2,464/21,064 [11.7%] vs 14,380/133,155 [10.8%]; P = .01). Mortality rates were higher among patients with malnutrition (905/21,064 [4.3%] vs 2,796/21,064 [2.1%],P < .01), and they had higher odds for mortality (adjusted odds ratio [aOR] = 2.1; CI, 1.7-2.5; P < .01). Those with malnutrition were less likely discharged home (aOR = 0.52; CI, 0.48-0.56; P < .01). Hospital charges were higher (adjusted mean difference [aMD] = +$42,540; CI, $36,934-48,146; P < .01) and length of stay longer (aMD = +4.3 days; CI, 3.9-4.7; P < .01) among patients with malnutrition. Conclusion: Malnutrition in hospitalized patients with CP is associated with increased mortality and hospital resource utilization. Flagging these patients as being "high risk" when they are hospitalized may result in heightened attentiveness about clinical outcomes in this vulnerable population.

Singing Therapy Improving Peak Flow, Speech and Eating Abilities in Adults with Cerebral Palsy

“…Eating dif-Open Journal of Therapy and Rehabilitation ficulties and poor nutritional status occur frequently in patients with CP [23] [24]. One study showed that malnutrition in hospitalized adults with CP is associated with increased mortality [8]. The present study indicates that singing is a useful tool to improve eating ability in adults with CP which potentially could counteract malnutrition.…”

“…The same study showed that around 35% of the CP individuals were underweight [7]. Malnutrition has not only been detected in children with mild-to-severe CP but also in adults with CP [8]. The nutritional status is worsening with increasing Gross Motor Function Classification System levels (GMFCS levels) both in regards to a higher prevalence and to multimorbidity [9] [10].…”

Prevalence and incidence of chronic conditions among adults with cerebral palsy: A systematic review and meta‐analysis

“…The prevalence of underweight was 11.8% and 17.6% among adults with intellectual disability and 0% among adults without intellectual disability 37,60 . The prevalence of malnutrition was 38.3% (95% CI = 7.6%–75.5%; I 2 = 99.5%, p < 0.01; n = 21 294 out of 15 4625; three studies) 59,61,63 . The prevalence of malnutrition was 48.8% among non‐ambulatory adults 59 …”

Prevalence and incidence of chronic conditions among adults with cerebral palsy: A systematic review and meta‐analysis

“…37,60 The prevalence of malnutrition was 38.3% (95% CI = 7.6%-75.5%; I 2 = 99.5%, p < 0.01; n = 21 294 out of 15 4625; three studies). 59,61,63 The prevalence of malnutrition was 48.8% among non-ambulatory adults. 59 There was no evidence that the prevalence of obesity was higher in adults with CP than in adults without CP.…”