Chiharu Uno1, Keisuke Maeda2, Hidetaka Wakabayashi3, Shinta Nishioka4, Nami Ogawa5, Takayuki Okamoto6, Kengo Hoyano7, Ryo Momosaki8. 1. Institute of Innovation for Future Society, Nagoya University, Nagoya City, Aichi, Japan; Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan. Electronic address: chiharu83724@gmail.com. 2. Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute City, Aichi, Japan. 3. Department of Rehabilitation Medicine, Yokohama City University Medical Center. Yokohama City, Kanagawa, Japan. 4. Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki City, Nagasaki, Japan. 5. Department of Gerontology and Gerodontology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan. 6. Department of Rehabilitation, Kurashiki Rehabilitation Hospital, Kurashiki City, Okayama, Japan. 7. Fukui Health Science University, Faculty of Health Science Department of Rehabilitation Division of Speech-Language-Hearing Therapy, eiheiji-cho, Yoshida-gun, Fukui, Japan. 8. Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawasaki city, Kanagawa, Japan.
Abstract
OBJECTIVE: The aim of this study was to examine the effect of improved nutritional status on activities of daily living (ADLs) and dysphagia in elderly patients with pneumonia who were admitted to acute care hospitals. METHODS: A retrospective cohort study was conducted using registry data from the Japan Rehabilitation Nutrition Database of patients with pneumonia who were admitted to acute care hospitals. Patients were divided into two groups based on the Mini Nutritional Assessment Short-Form (MNA-SF) status at discharge: Patients with no status change or with decreased status were allocated to the unimproved nutritional status (UN) group and those with increased status were assigned to the improved nutritional status (IN) group. The primary outcome was ADLs as assessed by Barthel Index (BI) score at hospital discharge. Secondary outcomes included dysphagia as assessed by the Food Intake Level Scale (FILS) at discharge. RESULTS: The study included 143 patients with a mean age of 84.7 ± 7.8 y. Based on the MNA-SF categories at discharge, 127 (88.8%) patients were assigned to the UN group and 16 (11.2%) to the IN group. Patients in the IN group had significantly higher BI and FILS scores than those in the UN group. Multiple regression analysis indicated that improvement in nutritional status was independently associated with BI gain (B = 9.916; β = 0.153; 95% confidence interval [CI], 1.929-11.761; P = 0.017) and FILS gain (B = 1.259; β = 0.167; 95% CI, 1.224-2.814; P = 0.044). CONCLUSIONS: Nutritional improvement is associated with improvements in ADL and dysphagia in patients with pneumonia and malnutrition.
OBJECTIVE: The aim of this study was to examine the effect of improved nutritional status on activities of daily living (ADLs) and dysphagia in elderly patients with pneumonia who were admitted to acute care hospitals. METHODS: A retrospective cohort study was conducted using registry data from the Japan Rehabilitation Nutrition Database of patients with pneumonia who were admitted to acute care hospitals. Patients were divided into two groups based on the Mini Nutritional Assessment Short-Form (MNA-SF) status at discharge: Patients with no status change or with decreased status were allocated to the unimproved nutritional status (UN) group and those with increased status were assigned to the improved nutritional status (IN) group. The primary outcome was ADLs as assessed by Barthel Index (BI) score at hospital discharge. Secondary outcomes included dysphagia as assessed by the Food Intake Level Scale (FILS) at discharge. RESULTS: The study included 143 patients with a mean age of 84.7 ± 7.8 y. Based on the MNA-SF categories at discharge, 127 (88.8%) patients were assigned to the UN group and 16 (11.2%) to the IN group. Patients in the IN group had significantly higher BI and FILS scores than those in the UN group. Multiple regression analysis indicated that improvement in nutritional status was independently associated with BI gain (B = 9.916; β = 0.153; 95% confidence interval [CI], 1.929-11.761; P = 0.017) and FILS gain (B = 1.259; β = 0.167; 95% CI, 1.224-2.814; P = 0.044). CONCLUSIONS: Nutritional improvement is associated with improvements in ADL and dysphagia in patients with pneumonia and malnutrition.
Authors: Mahmoud Y Shams; Omar M Elzeki; Lobna M Abouelmagd; Aboul Ella Hassanien; Mohamed Abd Elfattah; Hanaa Salem Journal: Comput Biol Med Date: 2021-06-30 Impact factor: 4.589