Clinical Indicators Associated with Unintentional Weight loss and Pressure Ulcers in Elderly Residents of Nursing Facilities
Identifieur interne : 004B13 ( Istex/Corpus ); précédent : 004B12; suivant : 004B14Clinical Indicators Associated with Unintentional Weight loss and Pressure Ulcers in Elderly Residents of Nursing Facilities
Auteurs : Shirley A. Gilmore ; Gretchen Robinson ; Mary Ellen Posthauer ; Janice RaymondSource :
- Journal of the American Dietetic Association [ 0002-8223 ] ; 1995.
Abstract
Objective To monitor adults older than 65 years living in nursing facilities and who experience unintentional weight loss of more than 10% of actual body weight in 6 months or more than 5% in 1 month or who have stage II, III, or IV pressure ulcers.Subjects We reviewed 290 medical records for unintentional weight loss and 265 for pressure ulcers.Design Two data-collecting instruments were used: one for pressure ulcers and one for unintentional weight loss. Indicators for each instrument were selected to monitor clinical conditions that tend to be problem-prone areas for these two populations.Statistical analysis Descriptive statistics were used to calculate the frequency of each indicator for each population.Results Of the 24 indicators for unintentional weight loss, the 6 indicators present most often, in descending order, were reduced functional ability, intake of 50% or less of food served for the past 3 consecutive days, chewing problems, serum albumin level less than 35 g/L with normal hydration status, cholesterol level less than 4.1 mmol/L, and refusal of 50% or more of food replacement for the past 7 days. For the residents with pressure ulcers, the indicator present most often was scrum albumin level less than 35 g/L with normal hydration status. The three highest intervention indicators were receives 1.2 g protein per kilogram of actual body weight, receives 120 mg or more of vitamin C daily, and receives 112 times the energy required based on goal body weight. When serum albumin level was documented in the medical record, it was a valid indicator for both diagnoses.Conclusions Inappropriate dietary intake, disease, and disability place residents in nursing facilities at risk for malnutrition. Thus, it is important to obtain laboratory values when assessing elderly residents and determining their nutritional status. J Am Diet Assoc. 1995; 95:984-992.
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DOI: 10.1016/S0002-8223(95)00271-5
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<front><div type="abstract" xml:lang="en">Objective To monitor adults older than 65 years living in nursing facilities and who experience unintentional weight loss of more than 10% of actual body weight in 6 months or more than 5% in 1 month or who have stage II, III, or IV pressure ulcers.Subjects We reviewed 290 medical records for unintentional weight loss and 265 for pressure ulcers.Design Two data-collecting instruments were used: one for pressure ulcers and one for unintentional weight loss. Indicators for each instrument were selected to monitor clinical conditions that tend to be problem-prone areas for these two populations.Statistical analysis Descriptive statistics were used to calculate the frequency of each indicator for each population.Results Of the 24 indicators for unintentional weight loss, the 6 indicators present most often, in descending order, were reduced functional ability, intake of 50% or less of food served for the past 3 consecutive days, chewing problems, serum albumin level less than 35 g/L with normal hydration status, cholesterol level less than 4.1 mmol/L, and refusal of 50% or more of food replacement for the past 7 days. For the residents with pressure ulcers, the indicator present most often was scrum albumin level less than 35 g/L with normal hydration status. The three highest intervention indicators were receives 1.2 g protein per kilogram of actual body weight, receives 120 mg or more of vitamin C daily, and receives 112 times the energy required based on goal body weight. When serum albumin level was documented in the medical record, it was a valid indicator for both diagnoses.Conclusions Inappropriate dietary intake, disease, and disability place residents in nursing facilities at risk for malnutrition. Thus, it is important to obtain laboratory values when assessing elderly residents and determining their nutritional status. J Am Diet Assoc. 1995; 95:984-992.</div>
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<abstract>Objective To monitor adults older than 65 years living in nursing facilities and who experience unintentional weight loss of more than 10% of actual body weight in 6 months or more than 5% in 1 month or who have stage II, III, or IV pressure ulcers.Subjects We reviewed 290 medical records for unintentional weight loss and 265 for pressure ulcers.Design Two data-collecting instruments were used: one for pressure ulcers and one for unintentional weight loss. Indicators for each instrument were selected to monitor clinical conditions that tend to be problem-prone areas for these two populations.Statistical analysis Descriptive statistics were used to calculate the frequency of each indicator for each population.Results Of the 24 indicators for unintentional weight loss, the 6 indicators present most often, in descending order, were reduced functional ability, intake of 50% or less of food served for the past 3 consecutive days, chewing problems, serum albumin level less than 35 g/L with normal hydration status, cholesterol level less than 4.1 mmol/L, and refusal of 50% or more of food replacement for the past 7 days. For the residents with pressure ulcers, the indicator present most often was scrum albumin level less than 35 g/L with normal hydration status. The three highest intervention indicators were receives 1.2 g protein per kilogram of actual body weight, receives 120 mg or more of vitamin C daily, and receives 112 times the energy required based on goal body weight. When serum albumin level was documented in the medical record, it was a valid indicator for both diagnoses.Conclusions Inappropriate dietary intake, disease, and disability place residents in nursing facilities at risk for malnutrition. Thus, it is important to obtain laboratory values when assessing elderly residents and determining their nutritional status. J Am Diet Assoc. 1995; 95:984-992.</abstract>
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<notesStmt><note type="content">Fig: Pressure ulcer stages (9).</note>
<note type="content">Table 1: Distribution of medical records related to indicators of unintentional weight loss in residents of nursing facilitiesa</note>
<note type="content">Table 2: Distribution of medical records related to indicators of stage II, III, and IV pressure ulcers in residents of nursing facilities</note>
<note type="content">Table 3: Indicator frequencies based on data in medical records of residents with unintentional weight loss in nursing facilitiesa</note>
<note type="content">Table 4: Indicator frequencies based on data in medical records of residents with stage II, III, and IV pressure ulcers in nursing facilities</note>
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<abstract xml:lang="en"><p>Objective To monitor adults older than 65 years living in nursing facilities and who experience unintentional weight loss of more than 10% of actual body weight in 6 months or more than 5% in 1 month or who have stage II, III, or IV pressure ulcers.Subjects We reviewed 290 medical records for unintentional weight loss and 265 for pressure ulcers.Design Two data-collecting instruments were used: one for pressure ulcers and one for unintentional weight loss. Indicators for each instrument were selected to monitor clinical conditions that tend to be problem-prone areas for these two populations.Statistical analysis Descriptive statistics were used to calculate the frequency of each indicator for each population.Results Of the 24 indicators for unintentional weight loss, the 6 indicators present most often, in descending order, were reduced functional ability, intake of 50% or less of food served for the past 3 consecutive days, chewing problems, serum albumin level less than 35 g/L with normal hydration status, cholesterol level less than 4.1 mmol/L, and refusal of 50% or more of food replacement for the past 7 days. For the residents with pressure ulcers, the indicator present most often was scrum albumin level less than 35 g/L with normal hydration status. The three highest intervention indicators were receives 1.2 g protein per kilogram of actual body weight, receives 120 mg or more of vitamin C daily, and receives 112 times the energy required based on goal body weight. When serum albumin level was documented in the medical record, it was a valid indicator for both diagnoses.Conclusions Inappropriate dietary intake, disease, and disability place residents in nursing facilities at risk for malnutrition. Thus, it is important to obtain laboratory values when assessing elderly residents and determining their nutritional status. J Am Diet Assoc. 1995; 95:984-992.</p>
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<head><ce:title>Clinical Indicators Associated with Unintentional Weight loss and Pressure Ulcers in Elderly Residents of Nursing Facilities</ce:title>
<ce:author-group><ce:author><ce:given-name>SHIRLEY A.</ce:given-name>
<ce:surname>GILMORE</ce:surname>
<ce:degrees>PhD, RD</ce:degrees>
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<ce:author><ce:given-name>GRETCHEN</ce:given-name>
<ce:surname>ROBINSON</ce:surname>
<ce:degrees>MS, RD, FADA</ce:degrees>
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<ce:author><ce:given-name>MARY ELLEN</ce:given-name>
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<ce:author><ce:given-name>JANICE</ce:given-name>
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<ce:textfn>S. A. Gilmore is an associate professor in the Hotel, Restaurant, and Institution Management Department, Iowa State University, Ames, Iowa, USA</ce:textfn>
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<ce:textfn>G. Robinson is a corporate dietitian with Health Care Facilities, Inc, Lima, Ohio, USA</ce:textfn>
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<ce:affiliation id="AFFC"><ce:label>c</ce:label>
<ce:textfn>M. E. Posthauer is with MEP Health care Dietary Services, Evansville, Ind, USA</ce:textfn>
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<ce:affiliation id="AFFD"><ce:label>d</ce:label>
<ce:textfn>J. Raymond is manager of medical education, Clintec Nutrition Company, Deerfield, Ill, USA</ce:textfn>
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<ce:text><ce:italic>Address correspondence to: Shirley A. Gilmore, PhD, RD, Hotel, Restaurant, and Institution Management Department, 11 MacKay Hall, Iowa State University, Ames IA 50011</ce:italic>
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<ce:abstract class="author"><ce:section-title>Abstract</ce:section-title>
<ce:abstract-sec><ce:simple-para view="all" id="simple-para.0035"><ce:bold>Objective</ce:bold>
To monitor adults older than 65 years living in nursing facilities and who experience unintentional weight loss of more than 10% of actual body weight in 6 months or more than 5% in 1 month or who have stage II, III, or IV pressure ulcers.</ce:simple-para>
<ce:simple-para view="all" id="simple-para.0040"><ce:bold>Subjects</ce:bold>
We reviewed 290 medical records for unintentional weight loss and 265 for pressure ulcers.</ce:simple-para>
<ce:simple-para view="all" id="simple-para.0045"><ce:bold>Design</ce:bold>
Two data-collecting instruments were used: one for pressure ulcers and one for unintentional weight loss. Indicators for each instrument were selected to monitor clinical conditions that tend to be problem-prone areas for these two populations.</ce:simple-para>
<ce:simple-para view="all" id="simple-para.0050"><ce:bold>Statistical analysis</ce:bold>
Descriptive statistics were used to calculate the frequency of each indicator for each population.</ce:simple-para>
<ce:simple-para view="all" id="simple-para.0055"><ce:bold>Results</ce:bold>
Of the 24 indicators for unintentional weight loss, the 6 indicators present most often, in descending order, were reduced functional ability, intake of 50% or less of food served for the past 3 consecutive days, chewing problems, serum albumin level less than 35 g/L with normal hydration status, cholesterol level less than 4.1 mmol/L, and refusal of 50% or more of food replacement for the past 7 days. For the residents with pressure ulcers, the indicator present most often was scrum albumin level less than 35 g/L with normal hydration status. The three highest intervention indicators were receives 1.2 g protein per kilogram of actual body weight, receives 120 mg or more of vitamin C daily, and receives 1<math altimg="si3.gif"><fr shape="case" align="c" style="s"><nu>1</nu>
<de>2</de>
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times the energy required based on goal body weight. When serum albumin level was documented in the medical record, it was a valid indicator for both diagnoses.</ce:simple-para>
<ce:simple-para view="all" id="simple-para.0060"><ce:bold>Conclusions</ce:bold>
Inappropriate dietary intake, disease, and disability place residents in nursing facilities at risk for malnutrition. Thus, it is important to obtain laboratory values when assessing elderly residents and determining their nutritional status. <ce:italic>J Am Diet Assoc. 1995; 95:984-992</ce:italic>
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<name type="personal"><namePart type="given">MARY ELLEN</namePart>
<namePart type="family">POSTHAUER</namePart>
<namePart type="termsOfAddress">RD</namePart>
<affiliation>M. E. Posthauer is with MEP Health care Dietary Services, Evansville, Ind, USA</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">JANICE</namePart>
<namePart type="family">RAYMOND</namePart>
<namePart type="termsOfAddress">MS, RD</namePart>
<affiliation>J. Raymond is manager of medical education, Clintec Nutrition Company, Deerfield, Ill, USA</affiliation>
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<typeOfResource>text</typeOfResource>
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<originInfo><publisher>ELSEVIER</publisher>
<dateIssued encoding="w3cdtf">1995</dateIssued>
<copyrightDate encoding="w3cdtf">1995</copyrightDate>
</originInfo>
<language><languageTerm type="code" authority="iso639-2b">eng</languageTerm>
<languageTerm type="code" authority="rfc3066">en</languageTerm>
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<abstract lang="en">Objective To monitor adults older than 65 years living in nursing facilities and who experience unintentional weight loss of more than 10% of actual body weight in 6 months or more than 5% in 1 month or who have stage II, III, or IV pressure ulcers.Subjects We reviewed 290 medical records for unintentional weight loss and 265 for pressure ulcers.Design Two data-collecting instruments were used: one for pressure ulcers and one for unintentional weight loss. Indicators for each instrument were selected to monitor clinical conditions that tend to be problem-prone areas for these two populations.Statistical analysis Descriptive statistics were used to calculate the frequency of each indicator for each population.Results Of the 24 indicators for unintentional weight loss, the 6 indicators present most often, in descending order, were reduced functional ability, intake of 50% or less of food served for the past 3 consecutive days, chewing problems, serum albumin level less than 35 g/L with normal hydration status, cholesterol level less than 4.1 mmol/L, and refusal of 50% or more of food replacement for the past 7 days. For the residents with pressure ulcers, the indicator present most often was scrum albumin level less than 35 g/L with normal hydration status. The three highest intervention indicators were receives 1.2 g protein per kilogram of actual body weight, receives 120 mg or more of vitamin C daily, and receives 112 times the energy required based on goal body weight. When serum albumin level was documented in the medical record, it was a valid indicator for both diagnoses.Conclusions Inappropriate dietary intake, disease, and disability place residents in nursing facilities at risk for malnutrition. Thus, it is important to obtain laboratory values when assessing elderly residents and determining their nutritional status. J Am Diet Assoc. 1995; 95:984-992.</abstract>
<note type="content">Fig: Pressure ulcer stages (9).</note>
<note type="content">Table 1: Distribution of medical records related to indicators of unintentional weight loss in residents of nursing facilitiesa</note>
<note type="content">Table 2: Distribution of medical records related to indicators of stage II, III, and IV pressure ulcers in residents of nursing facilities</note>
<note type="content">Table 3: Indicator frequencies based on data in medical records of residents with unintentional weight loss in nursing facilitiesa</note>
<note type="content">Table 4: Indicator frequencies based on data in medical records of residents with stage II, III, and IV pressure ulcers in nursing facilities</note>
<subject><genre>Article category</genre>
<topic>RESEARCH</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Journal of the American Dietetic Association</title>
</titleInfo>
<titleInfo type="abbreviated"><title>YJADA</title>
</titleInfo>
<genre type="Journal">journal</genre>
<originInfo><dateIssued encoding="w3cdtf">199509</dateIssued>
</originInfo>
<identifier type="ISSN">0002-8223</identifier>
<identifier type="PII">S0002-8223(00)X0086-7</identifier>
<part><date>199509</date>
<detail type="volume"><number>95</number>
<caption>vol.</caption>
</detail>
<detail type="issue"><number>9</number>
<caption>no.</caption>
</detail>
<extent unit="issue pages"><start>961</start>
<end>1072</end>
</extent>
<extent unit="pages"><start>984</start>
<end>992</end>
</extent>
</part>
</relatedItem>
<identifier type="istex">7D58E6229D94887D7C277BD92F95856064EEF8EE</identifier>
<identifier type="DOI">10.1016/S0002-8223(95)00271-5</identifier>
<identifier type="PII">S0002-8223(95)00271-5</identifier>
<identifier type="ArticleID">271</identifier>
<accessCondition type="use and reproduction" contentType="">© 1995American Dietetic Association</accessCondition>
<recordInfo><recordContentSource>ELSEVIER</recordContentSource>
<recordOrigin>American Dietetic Association, ©1995</recordOrigin>
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