The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients

Reijnierse, Esmee M.; Trappenburg, Marijke C.; Leter, Morena J.; Blauw, Gerard J.; Schueren, Marian A.E. de van der; Meskers, Carel G.M.; Maier, Andrea B.

doi:10.1371/journal.pone.0135933

Cited by 55 publications

(55 citation statements)

References 44 publications

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“…SGA identified malnutrition in 41% of the patients with most of them being considered moderately malnourished. Those findings were consistent with recent studies on this issue (9,17,18,21) . Furthermore, these results clearly shows that patients assessed in a ward setting present more frequent and severe malnutrition whatever the tool used to assess nutritional status.…”

Section: Discussionsupporting

confidence: 94%

“…Several reported studies have shown that functional status defined by handgrip strength correlates with severity of malnutrition and clinical outcome in different disease states (9,17,18,21) . More than a half of the tested patients in this sample displayed deficient/ low values in dynamometry, which was associated with the high prevalence of PCM detected in CLD patients as it was previously reported (4,8,13,14,19,23,27) .…”

Section: Discussionmentioning

confidence: 99%

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Outcome and Nutritional Assessment of Chronic Liver Disease Patients Using Anthropometry and Subjective Global Assessment

Nunes

Santos

Barosa

et al. 2017

Arq. Gastroenterol.

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-Background -Protein-calorie malnutrition is common in chronic liver disease (CLD) but adequate clinical tools for nutritional assessment are not defined. Objective -In CLD patients, it was aimed: 1. Characterize protein-calorie malnutrition; 2. Compare several clinical, anthropometric and functional tools; 3. Study the association malnutrition/CLD severity and malnutrition/outcome. Methods -Observational, prospective study. Consecutive CLD ambulatory/hospitalised patients were recruited from 01-03-2012 to 31-08-2012, studied according with age, gender, etiology, alcohol consumption and CLD severity defined by Child-Turcotte-Pugh. Nutritional assessment used subjective global assessment, anthropometry, namely body-mass index (BMI), triceps skinfold, mid upper arm circumference, mid arm muscular circumference and handgrip strength. Patients were followed during two years and survival data was recorded. Results -A total of 130 CLD patients (80 men), aged 22-89 years (mean 60 years) were included. Most suffered from alcoholic cirrhosis (45%). Hospitalised patients presented more severe disease (P<0.001) and worst nutritional status defined by BMI (P=0.002), mid upper arm circumference (P<0.001), mid arm muscular circumference (P<0.001), triceps skinfold (P=0.07) and subjective global assessment (P<0.001). A third presented deficient/low handgrip strength. Alcohol consumption (P=0.03) and malnutrition detected by BMI (P=0.03), mid upper arm circumference (P=0.001), triceps skinfold (P=0.06), mid arm muscular circumference (P=0.02) and subjective global assessment (P<0.001) were associated with CLD severity. From 25 patients deceased during follow-up, 17 patients were severely malnourished according with triceps skinfold. Malnutrition defined by triceps skinfold predicted mortality (P<0.001). Conclusion -Protein-calorie malnutrition is common in CLD patients and alcohol plays an important role. Triceps skinfold is the most efficient anthropometric parameter and is associated with mortality. Nutritional assessment should be considered mandatory in the routine care of CLD patients.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Outcome and Nutritional Assessment of Chronic Liver Disease Patients Using Anthropometry and Subjective Global Assessment

Nunes

Santos

Barosa

et al. 2017

Arq. Gastroenterol.

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“…Parameters of malnutrition were found to be associated with both relative and absolute muscle mass in geriatric outpatients [11]. The etiology of malnutrition in older patients is usually multifactorial and includes reduced nutritional intake and metabolic effects of illness [9].…”

Section: Introductionmentioning

confidence: 99%

High risk of malnutrition is associated with low muscle mass in older hospitalized patients - a prospective cohort study

et al. 2017

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BackgroundMalnutrition, low muscle strength and muscle mass are highly prevalent in older hospitalized patients and associated with adverse outcomes. Malnutrition may be a risk factor for developing low muscle mass. We aimed to investigate the association between the risk of malnutrition and 1) muscle strength and muscle mass at admission and 2) the change of muscle strength and muscle mass during hospitalization in older patients.MethodsThe EMPOWER study included 378 patients aged seventy years or older who were acutely or electively admitted to four different wards of an academic teaching hospital in Amsterdam. Patients were grouped into low risk of malnutrition and high risk of malnutrition based on the Short Nutritional Assessment Questionnaire (SNAQ) score and were assessed for hand grip strength and muscle mass using hand held dynamometry respectively bioelectrical impedance analysis (BIA) within 48 h after admission and at day seven, or earlier at the day of discharge. Muscle mass was expressed as skeletal muscle mass, appendicular lean mass, fat free mass and the skeletal muscle index.ResultsThe mean age of the patients was 79.7 years (SD 6.39), 48.9% were female. At admission, being at high risk of malnutrition was significantly associated with lower muscle mass (Odds Ratio, 95% CI, 0.90, 0.85–0.96), but not with muscle strength. Muscle strength and muscle mass did not change significantly during hospitalization in both groups.ConclusionIn older hospitalized patients, a high risk of malnutrition is associated with lower muscle mass at admission, but not with muscle strength nor with change of either muscle strength or muscle mass during hospitalization.

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“…Being underweight is associated with poor nutritional status, sarcopenia and related weakness of respiratory muscles, and frailty [16–18]. Such factors could adversely influence outcomes after major lung resection, as has been recently shown [8, 13].…”

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confidence: 99%

Operative Risk for Major Lung Resection Increases at Extremes of Body Mass Index

Williams

Gulack

Kim

et al. 2017

The Annals of Thoracic Surgery

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Background Although body mass index (BMI) has been used in risk stratification for lung resection, many models only take obesity into account. Recent studies have demonstrated that underweight patients also experience increased postoperative complications. We explored the relationship of extremes of BMI to outcomes after lung resection for non-small cell cancer. Methods Patients in the Society of Thoracic Surgeons General Thoracic Surgery Database (2009 to 2014) undergoing elective lung resection for cancer were evaluated. Multivariable logistic regression was used to adjust for potential confounders including functional status and spirometry. Results We evaluated 41,446 patients (median 68 years of age; 53% female) grouped by BMI: underweight (<18.5 kg/m2; 3.0%), normal (18.5 to 24.9 kg/m2; 33.5%), overweight (25 to 29.9 kg/m2; 35.4%), obese I (30 to 34.9 kg/m2; 18.1%), obese II (35 to 39.9 kg/m2; 6.4%), and obese III (≥40 kg/m2; 3.6%). Pulmonary complication rates were higher in underweight and obese III patients compared to normal BMI patients (p < 0.001). On multivariable analysis, compared to patients with normal BMI, being underweight was associated with an increased risk of pulmonary complications (adjusted odds ratio [OR]: 1.41, 95% confidence interval [CI]: 1.16 to 1.70) and any postoperative event (adjusted OR: 1.44, 95% CI: 1.26 to 1.64). Obese III patients had an increased risk of any major postoperative complication (adjusted OR: 1.18, 95% CI: 1.02 to 1.36). Overweight and obese class I to II patients had a lower risk of pulmonary complications and any postoperative event. Conclusions BMI is associated with postoperative complications after lung resection for cancer. Being underweight or severely overweight is associated with an increased risk of complications, whereas being overweight or moderately obese appears to have a protective effect.

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The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients

Cited by 55 publications

References 44 publications

Outcome and Nutritional Assessment of Chronic Liver Disease Patients Using Anthropometry and Subjective Global Assessment

Outcome and Nutritional Assessment of Chronic Liver Disease Patients Using Anthropometry and Subjective Global Assessment

High risk of malnutrition is associated with low muscle mass in older hospitalized patients - a prospective cohort study

Operative Risk for Major Lung Resection Increases at Extremes of Body Mass Index

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