Paradoxical Lower BMI and Albumin Decrease as Predictors of Mild Hospital-Acquired Pressure Injury in Older Adult Patients

Chiho Kai, Noriko Kurokawa, Yoko Hokotachi, Mari, Hasegawa and Teruyoshi Amagai

Administratiration Food Science and Nutrition Major, Graduate School of Human Environmental Sciences, Mukogawa Women's Univerisity, Japan
Department of Clinical Nutrition, Higashi Kobe Hospital, Japan
Department of Clinical Nutrition, Tominaga Hospital, Japan
Department of Clinical Nutrition, Takarazuka Dai-ichi Hospital, Japan

^*Correspondance to: Teruyoshi Amagai 

 PDF  Full Text DOI: 10.25107/2474-1647.2127

Abstract

Aim: To test the hypothesis that demographics, Pre-Pressure Injury (PI) nutrition care are associated with severe Hospital-Acquired PI (HAPI) in older adult patients.Methods: The study was conducted under a retrospective observational design in all consecutive patients admitted to a single general hospital during 24 months between July 2014 and June 2016. The inclusion criterion was a new PI developed after admission. Exclusion criteria were: 1) no PI at admission or during hospitalization, 2) PI already present at admission, 3) hospitalization extending beyond the end of the study period, 4) missing data, 5) serum creatinine and/or total bilirubin >1.5 mg/dl, 6) death within 14 days after PI development. Data collection: 1) demographics-sex, age, body mass index (BMI), Charlson comorbidity index; 2) PI parameters-severity of PI scored by NPUAP and DESIGN-R score, 3) laboratory parameters -hemoglobin, serum albumin (Alb), C-reactive protein; 4) nutrition parameters- daily energy and protein intakes during the 7 days before PI development, 5) outcome parameters-mortality rate, length of stay in hospital. Then, all collected data were compared between two groups divided by the severity of PI: mild vs. severe.Results: (1) HAPI prevalence and incidence were 1.73% and 1.20%, respectively. (2) Eighty percent of newly developed HAPI were mild. (3) The result showed a paradoxical association of lower BMI and albumin decrease after admission with mild HAPI development.Conclusion: A paradoxical lower BMI and Alb decrease seems to be predictors of mild HAPI in older patients.

Keywords

Pressure injury; BMI; Serum Albumin; Old adult

Cite the article

Kai C, Kurokawa N, Hokotachi Y, Hasegawa M, Amagai T. Paradoxical Lower BMI and Albumin Decrease as Predictors of Mild Hospital-Acquired Pressure Injury in Older Adult Patients. Clin Surg. 2018; 3: 2127.