Ability to predict six-month mortality and inter-tool agreement between four nutritional assessment instruments in the SAFES cohort.
Fiche publication
Date publication
octobre 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr JOLLY Damien
Tous les auteurs :
Komlanvi K, Jolly D, Vanaecke C, Mahmoudi R, Blanc P, Gauvain JB, Blanchard F, Novella JL, Drame M
Lien Pubmed
Résumé
Aim: To measure the ability to predict 6-month mortality of several different instruments for evaluating nutrition, and to compare agreement between results obtained with these different instruments. Methods: Prospective, multi-centre cohort study, including subjects aged 75 years or older, admitted to hospital through the emergency room. The predictive capacity of the different nutrition instruments (namely: Mini Nutritional Assessment (MNA), Geriatric Nutritional Risk Index (GNRI), body mass index (BMI) and albuminemia) were tested using a Cox model after adjustment for socio-demographic and clinical variables. Agreement between these four instruments was assessed by calculating Cohen's Kappa coefficient. Results: In total, 1306 subjects were included in the cohort, average age 85 +/- 6 years. The crude death rate at 6 months was 24.4%. Prevalence of malnutrition varied from 24 to 59%. All the nutrition instruments evaluated were significantly related to survival; the strongest associations with mortality were observed with GNRI (hazard ratio [HR] = 1.65; 95% CI = 1.31-2.06) and MNA (HR = 1.64; 95% CI = 1.27-2.03). Agreement between indicators was moderate to poor. Conclusion: The GNRI and the MNA appear to be the most useful tools for detecting malnutrition in elderly patients admitted via the emergency room. (C) 2012 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
Référence
. 2012 Oct;3(5):285-9.