Nicola Veronese1, Alberto Cella2, Alfonso J Cruz-Jentoft3, Maria Cristina Polidori4, Francesco Mattace-Raso5, Marc Paccalin6, Eva Topinkova7, Antonio Greco8, Arduino A Mangoni9, Julia Daragjati10, Giacomo Siri11, Alberto Pilotto12. 1. Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Geriatric Unit, E.O. Galliera Hospital, Genova, Italy; Azienda ULSS 3 Serenissima, Primary Care Department, District 3, Venice, Italy. Electronic address: ilmannato@gmail.com. 2. Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Geriatric Unit, E.O. Galliera Hospital, Genova, Italy. 3. Servicio de Geriatría, Hospital Universitario Ramón y Cajal(IRYCIS), Madrid, Spain. 4. Ageing Clinical Research, Dpt Medicine II, University Hospital of Cologne, Cologne, Germany. 5. Section of Geriatric Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands. 6. Geriatrics Department University Hospital Poitiers, France. 7. First Faculty of Medicine, Charles University in Prague, Czech Republic. 8. Geriatrics Unit, IRCCS CSS, San Giovanni Rotondo, Italy. 9. Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia. 10. Geriatrics Unit, AULSS 6 Euganea, San Antonio Hospital, Padova, Italy. 11. Scientific Coordination Unit, E.O. Galliera Hospital, Genova, Italy. 12. Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Geriatric Unit, E.O. Galliera Hospital, Genova, Italy; Department of Interdisciplinary Medicine, 'Aldo Moro' University of Bari, Italy.
Abstract
BACKGROUND & AIMS: The literature regarding enteral nutrition and mortality in older frail people is limited and still conflicting. Moreover, the potential role of comprehensive geriatric assessment is poorly explored. We therefore aimed to investigate whether the Multidimensional Prognostic Index (MPI), an established tool that assesses measures of frailty and predicts mortality, may help physicians in identifying patients in whom ETF (enteral tube feeding) is effective in terms of reduced mortality. METHODS: Observational, longitudinal, multicenter study with one year of follow-up. Data regarding ETF were recorded through medical records. A standardized comprehensive geriatric assessment was used to calculate the MPI. Participants were divided in low (MPI-1), moderate (MPI-2) or severe (MPI-3) risk of mortality. Data regarding mortality were recorded through administrative information. RESULTS: 1064 patients were included, with 79 (13 in MPI 1-2 and 66 in MPI-3 class) receiving ETF. In multivariable analysis, patients receiving ETF experienced a higher risk of death (odds ratio, OR = 2.00; 95% confidence intervals, CI: 1.19-3.38). However, after stratifying for their MPI at admission, mortality was higher in MPI-3 class patients (OR = 2.03; 95%CI: 1.09-3.76), but not in MPI 1-2 class patients (OR = 1.51; 95%CI: 0.44-5.25). The use of propensity score confirmed these findings. CONCLUSIONS: ETF is associated with a higher risk of death. However, this is limited to more frail patients, suggesting the importance of the MPI in the prognostic evaluation of ETF.
BACKGROUND & AIMS: The literature regarding enteral nutrition and mortality in older frail people is limited and still conflicting. Moreover, the potential role of comprehensive geriatric assessment is poorly explored. We therefore aimed to investigate whether the Multidimensional Prognostic Index (MPI), an established tool that assesses measures of frailty and predicts mortality, may help physicians in identifying patients in whom ETF (enteral tube feeding) is effective in terms of reduced mortality. METHODS: Observational, longitudinal, multicenter study with one year of follow-up. Data regarding ETF were recorded through medical records. A standardized comprehensive geriatric assessment was used to calculate the MPI. Participants were divided in low (MPI-1), moderate (MPI-2) or severe (MPI-3) risk of mortality. Data regarding mortality were recorded through administrative information. RESULTS: 1064 patients were included, with 79 (13 in MPI 1-2 and 66 in MPI-3 class) receiving ETF. In multivariable analysis, patients receiving ETF experienced a higher risk of death (odds ratio, OR = 2.00; 95% confidence intervals, CI: 1.19-3.38). However, after stratifying for their MPI at admission, mortality was higher in MPI-3 class patients (OR = 2.03; 95%CI: 1.09-3.76), but not in MPI 1-2 class patients (OR = 1.51; 95%CI: 0.44-5.25). The use of propensity score confirmed these findings. CONCLUSIONS: ETF is associated with a higher risk of death. However, this is limited to more frail patients, suggesting the importance of the MPI in the prognostic evaluation of ETF.
Authors: Alberto Pilotto; Carlo Custodero; Stefania Maggi; Maria Cristina Polidori; Nicola Veronese; Luigi Ferrucci Journal: Ageing Res Rev Date: 2020-03-21 Impact factor: 10.895
Authors: Alfonso J Cruz-Jentoft; Julia Daragjati; Laura Fratiglioni; Stefania Maggi; Arduino A Mangoni; Francesco Mattace-Raso; Marc Paccalin; Maria Cristina Polidori; Eva Topinkova; Luigi Ferrucci; Alberto Pilotto Journal: Aging Clin Exp Res Date: 2020-03-16 Impact factor: 3.636
Authors: Alberto Pilotto; Eva Topinkova; Helena Michalkova; Maria Cristina Polidori; Alberto Cella; Alfonso Cruz-Jentoft; Christine A F von Arnim; Margherita Azzini; Heidi Gruner; Alberto Castagna; Giovanni Cenderello; Romina Custureri; Carlo Custodero; Tania Zieschang; Alessandro Padovani; Elisabet Sanchez-Garcia; Nicola Veronese Journal: J Am Med Dir Assoc Date: 2022-07-01 Impact factor: 7.802