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Sarcopenia is predictive of nosocomial infection in care of the elderly

Published online by Cambridge University Press:  08 March 2007

Gaëlle Cosquéric ,
Aline Sebag ,
Cyril Ducolombier ,
Caroline Thomas ,
François Piette  and
Sébastien Weill-Engerer
Gaëlle Cosquéric
Affiliation:
Service de gériatrie, hôpital Rothschild, Assistance Publique – Hôpitaux de Paris, Paris, France
Aline Sebag
Affiliation:
Service de radiologie, hôpital Rothschild, Assistance Publique – Hôpitaux de Paris, Paris, France
Cyril Ducolombier
Affiliation:
Service de gériatrie, hôpital Rothschild, Assistance Publique – Hôpitaux de Paris, Paris, France
Caroline Thomas
Affiliation:
Service de gériatrie, hôpital Saint Antoine, Assistance Publique – Hôpitaux de Paris, Paris, France
François Piette
Affiliation:
Service de gériatrie, hôpital Rothschild, Assistance Publique – Hôpitaux de Paris, Paris, France
Sébastien Weill-Engerer*
Affiliation:
Service de gériatrie, hôpital Rothschild, Assistance Publique – Hôpitaux de Paris, Paris, France
*
*Corresponding author: Dr Sébastien Weill-Engerer, fax +33 1 40 19 33 64, email [email protected]
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Abstract

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Protein–energy malnutrition and nosocomial infection (NI) are frequent in elderly patients, and a causal link between the two has often been suggested. The aim of the present study was to identify the nutritional parameters predictive of NI in elderly patients. We assessed on admission 101 patients (sixty-six women, thirty-five men, aged over 65 years) admitted to an acute care of the elderly department. Sarcopenia was detected by dual-energy X-ray absorptiometry, with appendicular skeletal muscle mass expressed with respect to body area. Weight, BMI, albuminaemia, serum transthyretin and C-reactive protein values were also determined on admission, and known risk factors, such as functional dependence and invasive biomedical material, were also evaluated. After up to 3 weeks of hospitalisation, patients were classified according to whether they had developed an NI. After 3 weeks of hospitalisation, we found that twenty-nine patients had suffered an NI, occurring after a mean of 16·1 d. Patients who were sarcopenic on admission had a significantly higher risk of contracting an NI (relative risk 2·1, 95 % CI 1·1, 3·8). None of the other morphometric or biological parameters differed significantly between the two groups of patients on admission. Patients who experienced an NI were also more likely, on admission, to have a medical device (P=0·02 to P=0·001 depending on the device), to have swallowing problems (P=0·002) or to have restricted autonomy (P<0·01). Sarcopenia on admission to an acute care of the elderly unit, as measured by X-ray absorptiometry, was therefore associated with a doubled risk of NI during the first 3 weeks of hospitalisation.

Keywords

Protein–energy malnutritionAgedFrail elderlyNosocomial infectionSarcopenia
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 5 , November 2006 , pp. 895 - 901
Copyright
Copyright © The Nutrition Society 2006

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