Dolores Sánchez-Rodríguez1, Ester Marco2, Natalia Ronquillo-Moreno3, Liev Maciel-Bravo3, Abel Gonzales-Carhuancho4, Xavier Duran5, Anna Guillén-Solà6, Olga Vázquez-Ibar7, Ferran Escalada6, Josep M Muniesa6. 1. Geriatrics Department, Parc de Salut Mar, Centre Fòrum - Hospital del Mar, Barcelona, Spain; Rehabilitation Research Group, Institut Hospital del Mar d' Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain. Electronic address: 97662@parcdesalutmar.cat. 2. Rehabilitation Research Group, Institut Hospital del Mar d' Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain. 3. Geriatrics Department, Parc de Salut Mar, Centre Fòrum - Hospital del Mar, Barcelona, Spain. 4. Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain. 5. Methodology and Biostatistics Support Unit, Institut Hospital del Mar d' Investigacions Mèdiques (IMIM), Barcelona, Spain. 6. Rehabilitation Research Group, Institut Hospital del Mar d' Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain. 7. Geriatrics Department, Parc de Salut Mar, Centre Fòrum - Hospital del Mar, Barcelona, Spain; School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain.
Abstract
BACKGROUND: The aim of this study was to assess the prevalence of malnutrition by applying the ASPEN/AND definition and the ESPEN consensus definition in a postacute-care population, and secondly, to determine the metrological properties of the set of six clinical characteristics that constitute the ASPEN/AND basic diagnosis, compared to the ESPEN consensus, based mostly on objective anthropometric measurements. METHODS: Prospective study of 84 consecutive deconditioned older inpatients (85.4 ± 6.2; 59.5% women) admitted for rehabilitation in postacute care. ASPEN/AND diagnosis of malnutrition was considered in presence of at least two of the following: low energy intake, fluid accumulation, diminished handgrip strength, and loss of weight, muscle mass, or subcutaneous fat. Sensitivity, specificity, positive and negative predictive values, accuracy, likelihood ratios, and kappa statistics were calculated for ASPEN/AND criteria and compared with ESPEN consensus. RESULTS: The prevalence of malnutrition by ASPEN/AND criteria was 63.1% and by ESPEN consensus, 20.2%; both diagnoses were associated with significantly longer length of stay, but the ESPEN definition was significantly associated with poorer functional outcomes after the rehabilitation program. Compared to ESPEN consensus, ASPEN/AND diagnosis showed fair validity (sensitivity = 94.1%; specificity = 44.8%); kappa statistic was 2.217. CONCLUSIONS: Applying the ASPEN/AND definition obtained a higher prevalence of malnutrition in a postacute-care population than was identified by the ESPEN definition. ASPEN/AND criteria had fair validity and agreement compared with the ESPEN definition. A simple, evidence-based, unified malnutrition definition might improve geriatric care.
BACKGROUND: The aim of this study was to assess the prevalence of malnutrition by applying the ASPEN/AND definition and the ESPEN consensus definition in a postacute-care population, and secondly, to determine the metrological properties of the set of six clinical characteristics that constitute the ASPEN/AND basic diagnosis, compared to the ESPEN consensus, based mostly on objective anthropometric measurements. METHODS: Prospective study of 84 consecutive deconditioned older inpatients (85.4 ± 6.2; 59.5% women) admitted for rehabilitation in postacute care. ASPEN/AND diagnosis of malnutrition was considered in presence of at least two of the following: low energy intake, fluid accumulation, diminished handgrip strength, and loss of weight, muscle mass, or subcutaneous fat. Sensitivity, specificity, positive and negative predictive values, accuracy, likelihood ratios, and kappa statistics were calculated for ASPEN/AND criteria and compared with ESPEN consensus. RESULTS: The prevalence of malnutrition by ASPEN/AND criteria was 63.1% and by ESPEN consensus, 20.2%; both diagnoses were associated with significantly longer length of stay, but the ESPEN definition was significantly associated with poorer functional outcomes after the rehabilitation program. Compared to ESPEN consensus, ASPEN/AND diagnosis showed fair validity (sensitivity = 94.1%; specificity = 44.8%); kappa statistic was 2.217. CONCLUSIONS: Applying the ASPEN/AND definition obtained a higher prevalence of malnutrition in a postacute-care population than was identified by the ESPEN definition. ASPEN/AND criteria had fair validity and agreement compared with the ESPEN definition. A simple, evidence-based, unified malnutrition definition might improve geriatric care.
Authors: Daniel V Runco; Karen Wasilewski-Masker; Courtney E McCracken; Martha Wetzel; Claire M Mazewski; Briana C Patterson; Ann C Mertens Journal: Clin Nutr ESPEN Date: 2020-06-02
Authors: Cristina Martins; Simone L Saeki; Marcelo Mazza do Nascimento; Fernando M Lucas Júnior; Ana Maria Vavruk; Christiane L Meireles; Sandra Justino; Denise Mafra; Estela Iraci Rabito; Maria Eliana Madalozzo Schieferdecker; Letícia Fuganti Campos; Denise P J van Aanholt; Ana Adélia Hordonho; Marcia Samia Pinheiro Fidelix Journal: J Bras Nefrol Date: 2021 Apr-Jun
Authors: Daniel V Runco; Karen Wasilewski-Masker; Claire M Mazewski; Briana C Patterson; Ann C Mertens Journal: J Pediatr Hematol Oncol Date: 2021-11-01 Impact factor: 1.170