Nutritional Predictors of Mortality after Discharge in Older Patients with type 2 Diabetes

Abstract

Background: Older patient with type 2 diabetes (T2D) and malnutrition have a greater chance of negative events during hospitalization and a higher risk of mortality. The aim of this study was to investigate nutritional markers as mortality predictors following discharge hospitalized older patients with T2D. Methods: This is a prospective cohort study with follow-up of four years. All patients were subjected to Mini Assessment Nutrition, Subjective Global Assessment, calf circumference, arm circumference and adductor pollicis muscle thickness, obtained all within 48 h of admission. Mortality data were verified by medical registry and analyzed using Cox-proportional hazard models and survival curves. Results: 311 patients were included; the mean age was 71.35 years. There were 113 (36.3 %) deaths in the follow-up period. Nutritional status evaluated according to BMI identified 54.5% (n = 168) were overweight, for other hand the MAN identified 45.7% of patients were at risk of malnutrition and 37.7% malnutrition and the SGA identify 61.7% (n = 192) presented normal nutrition in admission. Malnutrition patients (OR=2.02), with low calf circumference (OR=1.43) or with APMT less than 5th percentile (2.33) were associated with post-discharge mortality. Conclusion: Malnutrition, reduced calf circumference and reduced APMT were nutritional predictors of mortality after hospital discharge in older patients with diabetes