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Impact of Energy intake at One Week after Hospitalization on Prognosis for Older Adults with Pneumonia

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The journal of nutrition, health & aging

Abstract

Objectives

This study objectives to investigate the influence of average energy intake at 1 week of hospitalization on prognosis for older adults with pneumonia.

Design

Retrospective observational cohort study.

Setting

The Japan Rehabilitation Nutrition Database comprise those with pneumonia in acute care hospitals.

Participants

The study included 329 pneumonia patients (aged over 65 years) who entered into the Japan Rehabilitation Nutrition Database (JRND) from November 2015 to March 2018.

Measurements

Logistic regression analysis was performed to confirm the relationship of energy intake with the rate of mortality, discharge home, and pneumonia recurrence during hospitalization. Variables included in the multiple regression analysis model were age, sex, Mini Nutritional Assessment-Short Form score (MNA-SF) at hospitalization, A-DROP, Charlson comorbidity index (CCI), and presence or absence of rehabilitation.

Results

Of 315 patients with pneumonia (median age 85 years), 63.8% were men. 57.7% were assigned to the lack of energy intake (LEI) at 1 week after admission. Patients in the LEI group were older (p = 0.033), had higher A-DROP score (p < 0.001), and showed higher malnutrition rate in MNA-SF at hospitalization (p < 0.001) than those in the control group. Mortality, pneumonia recurrence (p = 0.001), median body mass index (p = 0.012), and low malnutrition in MNA-SF (p < 0.001) at discharge were significantly higher in the LEI group than in the control group. Logistic regression analysis showed that LEI was an independent risk factor for mortality (Odds ratio: 5.07, p = 0.002), discharge home (Odds ratio: 0.33, p = 0.007), and pneumonia recurrence (Odds ratio: 3.26, p = 0.007).

Conclusions

LEI at 1 week after hospitalization in older adults with pneumonia was an independent risk factor for mortality, difficult at-home recovery, and pneumonia recurrence. These findings suggest the importance of adequate energy intake from the early days of hospitalization.

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Acknowledgements

The authors express appreciation to all participating facilities and registered personnel involved with the database. This study was supported by the Japan Society for the Promotion of Science (Grant Number 18K10690).

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Iizuka Hospital, Iizuka, Fukuoka, Japan

    Kengo Shirado

  2. Department of Rehabilitation Medicine, Yokohama City University Medical Center, Minami Ward, Yokohama, Japan

    H. Wakabayashi

  3. Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan

    K. Maeda

  4. Department of Clinical Nutrition and Food Service, Yasuoka Hospital, Shimonoseki, Yamaguchi, Japan

    A. Nishiyama

  5. Matsushita Memorial Hospital, Moriguchi City, Osaka, Japan

    M. Asada

  6. Ai Home Dental Clinic, Toyohashi, Aichi, Japan

    H. Isse

  7. Department of Rehabilitation, New Tokyo Hospital, Matsudo-shi, Chiba, Japan

    S. Saito

  8. Yoshida Hospital, Hyogo-ku, Kobe City, Hyogo, Japan

    C. Kakitani

  9. Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa, Japan

    R. Momosaki

  10. R.P.T. Department of Rehabilitation, Aso Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, 820-8505, Japan

    Kengo Shirado

Authors
  1. Kengo Shirado
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  2. H. Wakabayashi
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  3. K. Maeda
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  4. A. Nishiyama
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  5. M. Asada
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  7. S. Saito
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Corresponding author

Correspondence to Kengo Shirado.

Ethics declarations

Disclosure statement: Each author (Kengo Shirado, Hidetaka Wakabayashi, Keisuke Maeda, Ai Nishiyama, Munetaka Asada, Hirotaka Isse, Sachiko Saito, Chisa Kakitani, Ryo Momosaki) declares not to be involved in any financial interest or relationship with a commercial interest held by the individual or members of their family (spouses, domestic partners and dependent children) over the preceding twelve months. They also are not involved in any conflicts of interest, and off-label or investigational use. Dr. Wakabayashi reports grants from Grant-in-Aid for Scientific Research (B) of Japan Society for the Promotion of Science, outside the submitted work; Dr. Maeda reports grants from Grant-in-Aid for Scientific Research (C) of Japan Society for the Promotion of Science, outside the submitted work; Dr. Momosaki reports grants from Grant-in-Aid for Scientific Research (C) of Japan Society for the Promotion of Science, outside the submitted work; .

Ethical standards: The study was approved by the ethics committee of Teikyo University. This study complies with the Japanese ethical guidelines for epidemiological research.

Additional information

Authorship Statement: Kengo. Shirado: designed research/study, performed research/ study, collected data, analyzed data, wrote the paper; Hidetaka Wakabayashi: designed research/study, performed research/study, collected data, analyzed data, wrote the paper; Keisuke Maeda: designed research/study, performed research/study, collected data, analyzed data, wrote the paper; Ai Nishiyama: designed research/study, performed research/study, collected data, analyzed data, wrote the paper; Munetaka Asada: designed research/study, performed research/study; Hirotaka Isse: designed research/study, performed research/study; Sachiko Saito: designed research/study, performed research/ study; Chisa Kakitani: designed research/study, performed research/study; Ryo Momosaki: designed research/study, performed research/study, collected data, analyzed data, wrote the paper; All authors approved the final version of the manuscript.

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Shirado, K., Wakabayashi, H., Maeda, K. et al. Impact of Energy intake at One Week after Hospitalization on Prognosis for Older Adults with Pneumonia. J Nutr Health Aging 24, 119–124 (2020). https://doi.org/10.1007/s12603-019-1282-y

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  • DOI: https://doi.org/10.1007/s12603-019-1282-y

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