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Published on: January 29, 2018
Malnutrition in Hospitalized Adults With Cerebral Palsy
Ché Matthew Harris1,2, Scott Mitchell Wright1,2
1Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Insights
Malnutrition significantly increases mortality and hospital resource use in adults with cerebral palsy (CP). Identifying these high-risk patients is crucial for improving their clinical outcomes.
Area of Science:
- Clinical Nutrition
- Public Health
- Neurology
Background:
- Malnutrition in adults with cerebral palsy (CP) is understudied.
- This research investigates the clinical and resource implications of malnutrition in hospitalized CP patients.
Purpose of the Study:
- To determine the impact of malnutrition on mortality and resource utilization in hospitalized adults with CP.
- To highlight the need for recognizing malnutrition as a critical factor in CP patient care.
Main Methods:
- Retrospective cohort study using the National Inpatient Sample database (2016-2017).
- Regression models were employed to assess mortality and resource utilization.
- Analyzed data from 154,219 adult hospitalizations with CP.
Main Results:
- 13.5% of hospitalized adults with CP had malnutrition.
- Malnourished CP patients exhibited higher mortality rates (4.3% vs 2.1%) and increased odds of death (aOR=2.1).
- Malnutrition was linked to lower home discharge rates, increased hospital charges (+$42,540), and longer hospital stays (+4.3 days).
Conclusions:
- Malnutrition is a significant predictor of adverse outcomes in hospitalized adults with CP.
- Increased mortality and hospital resource utilization are associated with malnutrition in this population.
- Identifying malnourished CP patients as high-risk is essential for targeted clinical attention and improved outcomes.
Background:
Malnutrition among hospitalized adults with cerebral palsy (CP) has not been extensively explored. We sought to identify impacts of malnutrition on clinical and resource outcomes among hospitalized adults with CP.
Methods:
This retrospective cohort study surveyed years 2016 and 2017 from the National Inpatient Sample database. Regression models evaluated mortality and resource utilization.
Results:
154,219 adults with CP were hospitalized. Among them, 21,064/154,219 (13.5%) had malnutrition. Patients with and without malnutrition were similar in age (mean age ± SEM, 45.1 ± 0.30 vs 45.2 ± 0.18 years; P = .70). Patients with malnutrition were more likely male (12,175/21,604 [57.8%] vs 72,929/133,155 [54.8%], P < .01) and had higher comorbidity scores (Charlson comorbidity score ≥ 3; 2,464/21,064 [11.7%] vs 14,380/133,155 [10.8%]; P = .01). Mortality rates were higher among patients with malnutrition (905/21,064 [4.3%] vs 2,796/21,064 [2.1%], P < .01), and they had higher odds for mortality (adjusted odds ratio [aOR] = 2.1; CI, 1.7-2.5; P < .01). Those with malnutrition were less likely discharged home (aOR = 0.52; CI, 0.48-0.56; P < .01). Hospital charges were higher (adjusted mean difference [aMD] = +$42,540; CI, $36,934-48,146; P < .01) and length of stay longer (aMD = +4.3 days; CI, 3.9-4.7; P < .01) among patients with malnutrition.
Conclusion:
Malnutrition in hospitalized patients with CP is associated with increased mortality and hospital resource utilization. Flagging these patients as being "high risk" when they are hospitalized may result in heightened attentiveness about clinical outcomes in this vulnerable population.
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