Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Original Article

Volume 11, Number 7, July 2019, pages 472-479


Association Between Risk Factors and Intensive Nutritional Intervention Outcomes in Elderly Individuals

Figure

Figure 1.
Figure 1. Flow chart of participant selection in this study.

Tables

Table 1. Characteristics of the Participants
 
Successful group (n = 140)Non-successful group (n = 90)P value
Data are expressed as median (25th - 75th percentile) or percentage (n). The differences between the two groups were analyzed using the Fisher’s exact test, Chi-square test, and Mann-Whitney U test. BMI: body mass index; CCI: Charlson Comorbidity Index; SGA: subjective global assessment; %TEE: the energy fill rate to total energy expenditure; NST: nutrition support team.
Age (years)85.0(79.0 - 89.0)84.0(78.8 - 89.0)0.426
Sex (men)35.0%(49)51.1%(46)0.020
BMI (kg/m2)18.7(16.4 - 21.0)18.4(16.1 - 21.5)0.863
  Lack of data(3)(5)
CCI (points)
  Low, 017.9%(25)15.6%(14)0.464
  Medium, 1 - 246.4%(65)42.2%(38)
  High, 3 - 420.7%(29)18.9%(17)
  Very high, ≥ 515.0%(21)23.3%(21)
SGA score (points)
  Normal, 011.4%(15)5.8%(5)0.102
  Light, 1 - 234.1%(45)24.4%(21)
  Moderate, 3 - 434.1%(45)48.8%(42)
  Severe, 5 - 1020.5%(27)20.9%(18)
  Lack of data(8)(4)
Presence of dysphagia48.9%(68)58.9%(53)0.175
  Lack of data(1)(0)
Presence of bedsore11.4%(15)17.4%(15)0.230
  Lack of data(8)(4)
%TEE (%)66.0(44.8 - 82.1)56.3(36.2 - 73.2)0.004
Duration of NST intervention (days)36.0(22.0 - 50.0)22.0(14.0 - 43.0)< 0.001

 

Table 2. Laboratory Examination Results
 
Successful group (n = 140)Non-successful group (n = 90)P value
nn
Data are expressed as median (25th - 75th percentile). The differences between the two groups were analyzed using the Mann-Whitney U test. Alb: albumin; TLC: total lymphocyte count; T-Cho: total cholesterol; CRP: C-reactive protein; TTR: transthyretin; Hb: hemoglobin; TG: triglyceride; CONUT: controlling nutritional status; PNI: Onodera’s prognostic nutritional index; GNRI: geriatric nutritional risk index.
Alb level (g/dL)1402.4(2.0 - 2.7)902.2(1.8 - 2.6)0.004
TLC level (/µL)1361,160(825 - 1575)861,100(760 - 1605)0.710
T-Cho level (mg/dL)122137(106 - 160)76133(102 - 161)0.771
CRP level (mg/dL)1392.16(0.83 - 4.80)904.25(1.39 - 9.08)0.001
TTR level (mg/dL)11310.4(7.5 - 14.0)688.3(5.2 - 10.8)0.002
Hb level (g/dL)1399.2(8.4 - 10.5)909.2(8.3 - 10.6)0.930
TG level (mg/dL)12290(63 - 111)6989(66 - 116)0.607
CONUT score1228.0(6.0 - 10.0)768.5(7.0 - 10.0)0.304
PNI score13629.6(25.8 - 34.5)8627.2(23.3 - 32.5)0.017
GNRI score13772.0(64.3 - 78.2)8567.8(61.0 - 73.4)0.003

 

Table 3. Methods Used to Supply Nutrients at the Time of NST Enrollment
 
Successful group (n = 140)Non-successful group (n = 90)P value
Data are expressed as percentage (n). The differences between the two groups were analyzed using the Fisher’s exact test. PEG: percutaneous endoscopic gastrostomy.
Total parenteral nutrition16.4%(23)24.4%(22)0.173
Peripheral parenteral nutrition32.1%(45)47.8%(43)0.019
Nasal tube feeding6.4%(9)4.4%(4)0.771
Gastric fistula (PEG)6.4%(9)2.2%(2)0.209
Regular texture diet (including therapeutic diet)50.7%(71)46.7%(42)0.590
Oral supplementation (including enteral nutrient)60.0%(84)63.3%(57)0.678
Dysphagia diet35.7%(50)41.1%(37)0.486

 

Table 4. Results of the Univariate and Multivariate Cox Proportional Hazard Analyses of the NST Intervention Outcomes
 
Successful groupNon-successful groupP valueaUnivariate analysisP valueMultivariate analysisbP value
% (n)% (n)HR (95% CI)HR (95% CI)
aFisher’s exact test. bModel included age, sex, CCI score, SGA score, %TEE, TLC, CRP, GNRI score, and PPN. HR: hazard ratio; CI: confidence interval; BMI: body mass index; CCI: Charlson Comorbidity Index; SGA: subjective global assessment; %TEE: the energy fill rate to total energy expenditure; Alb: albumin; TLC: total lymphocyte count; CRP: C-reactive protein; TTR: transthyretin; CONUT: controlling nutritional status; PNI: Onodera’s prognostic nutritional index; GNRI: geriatric nutritional risk index; PPN: peripheral parental nutrition.
Age (years)
  < 8549.3% (69)53.3% (48)0.59010.28510.368
  ≥ 8550.7% (71)46.7% (42)0.80 (0.52 - 1.21)0.81 (0.51 - 1.29)
Sex
  Women65.0% (91)48.9% (44)0.02010.17310.812
  Men35.0% (49)51.1% (46)1.34 (0.88 - 2.03)1.06 (0.66 - 1.71)
BMI (kg/m2)
  ≥ 18.551.8% (71)49.4% (42)0.78310.332
  < 18.548.2% (66)50.6% (43)1.24 (0.81 - 1.90)
CCI (points)
  < 226.4% (37)22.2% (20)0.53310.62710.937
  ≥ 273.6% (103)77.8% (70)1.13 (0.69 - 1.86)1.02 (0.59 - 1.77)
SGA score (points)
  < 343.9% (58)29.1% (25)0.03210.06210.259
  ≥ 356.1% (74)70.9% (61)1.56 (0.98 - 2.49)1.34 (0.81 - 2.20)
%TEE (%)
  ≥ 66.050.0% (70)32.2% (29)0.01010.00910.061
  < 66.050.0% (70)67.8% (61)1.82 (1.16 - 2.83)1.61 (0.98 - 2.66)
Alb level (g/dL)
  ≥ 2.457.9% (81)37.8% (34)0.00410.015
  < 2.442.1% (59)62.2% (56)1.70 (1.11 - 2.61)
TLC level (/µL)
  ≥ 1,19545.6% (62)44.2% (38)0.89010.51310.642
  < 1,19554.4% (74)55.8% (48)1.15 (0.75 - 1.77)0.89 (0.55 - 1.45)
CRP level (mg/dL)
  < 2.0046.8% (65)28.9% (26)0.00910.01310.103
  ≥ 2.0053.2% (74)71.1% (64)1.79 (1.13 - 2.83)1.55 (0.92 - 2.62)
TTR level (mg/dL)
  ≥ 8.569.9% (79)48.5% (33)0.00510.006
  < 8.530.1% (34)51.5% (35)1.97 (1.22 - 3.19)
CONUT score
  ≤ 741.8% (51)36.8% (28)0.55110.414
  ≥ 858.2% (71)63.2% (48)1.22 (0.76 - 1.94)
PNI score
  ≥ 33.032.4% (44)23.3% (20)0.17210.063
  < 33.067.6% (92)76.7% (66)1.61 (0.98 - 2.67)
GNRI score
  ≥ 70.057.0% (77)38.8% (33)0.01210.00910.099
  < 70.043.0% (58)61.2% (52)1.80 (1.16 - 2.79)1.54 (0.92 - 2.56)
PPN
  Absence67.9% (95)52.2% (47)0.01910.00410.014
  Presence32.1% (45)47.8% (43)1.86 (1.22 - 2.84)1.80 (1.13 - 2.88)