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Nutritional screening of older people
in a sub-acute care facility in Australia
and its relation to discharge outcomes |
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Objectives: to determine the prevalence of under-nutrition using brief screening methods and to determine the relation between these results and (1) those of a more standard nutritional assessment and (2) discharge outcomes.
Design: prospective study.
Subjects: 65 (21 males) patients older than 65 years.
Setting: sub-acute care facility.
Measurements: the Mini Nutritional Assessment, standard nutritional assessment, ‘rapid screen’ and discharge outcome. Results: the prevalence of under-nutrition was high, ranging from 35.4% to 43.1%, depending on the screening method used. Compared to the standard nutritional assessment the ‘rapid screen’ consisting of (1) body mass index <22 kg/m2; and/or
(2) reported weight loss of > 7.5% over the previous 3 months and the two-tiered Mini Nutritional Assessment process (atrisk
subjects (46% of total) further evaluated using standard nutritional assessment) had sensitivities of 78.6 and 89.5% and speciWcities of 97.3 and 87.5% respectively in diagnosing under-nutrition. Under-nourished patients as identiWed by the standard nutritional assessment (50.0% (under-nourished) versus 21.6% (nourished); P = 0.017), the two-tiered Mini Nutritional
Assessment process (50.0% (under-nourished) versus 21.6% (nourished); P = 0.017) and the rapid screen (56.5% (under-nourished) versus 21.4% (nourished); P =0.004) were more likely to be discharged to an acute hospital or an accommodation
with increased support (poor discharge outcomes) than nourished patients. Conclusion: all screening methods identiWed patients more likely to have a poor discharge outcome. The highly speciWc but less sensitive ‘rapid screen’ may be the best method in facilities with limited resources as it can be easily incorporated into nursing/medical admissions and avoids biochemical investigations in all patients. The more sensitive two-tiered Mini Nutritional Assessment is better if resources permit. |
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| Type |
Journal - Bibliographic Record |
Resource Type
(If applicable)
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| Author(s) |
RENUKA VISVANATHAN, ROBERT PENHALL, IAN CHAPMAN |
| Book Publisher |
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| Journal Publisher |
Age Ageing |
| Year |
2004 |
| Pages |
260-265 |
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| Edition |
V 33 |
Contact Information
(If applicable)
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Comments
(If applicable)
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National Resource Center on Nutrition, Physical Activity & Aging | Florida International University, OE 200, Miami, FL 33199
Phone: 305-348-1517 | Fax: 305-348-1518 | E-mail: nutrionandaging@fiu.edu
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