TY - JOUR
T1 - Enteral tube feeding and mortality in hospitalized older patients
T2 - A multicenter longitudinal study
AU - Veronese, Nicola
AU - Cella, Alberto
AU - Cruz-Jentoft, Alfonso J.
AU - Polidori, Maria Cristina
AU - Mattace-Raso, Francesco
AU - Paccalin, Marc
AU - Topinkova, Eva
AU - Greco, Antonio
AU - Mangoni, Arduino A.
AU - Daragjati, J.
AU - Siri, Giacomo
AU - Pilotto, Alberto
AU - MPI_AGE Investigators
AU - Musacchio, Clarissa
AU - Custureri, Romina
AU - Puntoni, Matteo
AU - Simonato, Matteo
AU - Durando, Mario
AU - Miret-Corchado, Carmen
AU - Montero-Errasquin, Beatriz
AU - Meyer, Anna
AU - Hoffmann, Dirk
AU - Schulz, Ralf Joachim
AU - Tap, Lisanne
AU - Egberts, Angelique
AU - Bureau, Marie Laure
AU - Brunet, Thomas
AU - Liuu, Evelyne
AU - Michalkova, Helena
AU - Madlova, Pavla
AU - Sancarlo, Daniele
AU - D'Onofrio, Grazia
AU - Ruxton, Kimberley
AU - Maggi, Stefania
AU - Ferrucci, Luigi
PY - 2020/5
Y1 - 2020/5
N2 - 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.
AB - 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.
KW - Enteral nutrition
KW - Hospital
KW - Multidimensional prognostic index
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85069952743&partnerID=8YFLogxK
U2 - 10.1016/j.clnu.2019.07.011
DO - 10.1016/j.clnu.2019.07.011
M3 - Article
AN - SCOPUS:85069952743
SN - 0261-5614
VL - 39
SP - 1608
EP - 1612
JO - Clinical Nutrition
JF - Clinical Nutrition
IS - 5
ER -