Clinical Interventions in Aging (May 2023)
Factors Associated with In-Hospital Mortality in Elderly Internal Medicine Patients with Nasogastric Tube Feeding
Abstract
Galina Plotnikov,1,2 Saleh Sharif,2,3 Gleb Buturlin,2 Inbal Segal,1 Oleg Gorelik,2 Nadya Kagansky2,4 1Geriatric Assessment Unit, Yitzhak Shamir Medical Center, Zerifin, 7033001, Israel; 2Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel; 3Department of Internal Medicine C, Yitzhak Shamir Medical Center, Zerifin, 7033001, Israel; 4Shmuel Harofe Geriatric Medical Center, Beer Yaakov, IsraelCorrespondence: Galina Plotnikov, Geriatric Assessment Unit, Yitzhak Shamir Medical Center, Zerifin, 7033001, Israel, Tel +972-8-9542271, Fax +972-8-9779597, Email [email protected]: To evaluate demographic, clinical, and laboratory variables, and their associations with in-hospital mortality, among elderly internal medicine patients with nasogastric tube (NGT) feeding.Patients and Methods: Demographic, clinical, and laboratory data were collected retrospectively for 129 patients aged ≥ 80 years who initiated NGT feeding during their hospitalization in internal medicine wards. The data were compared between survivors and non-survivors. Multivariate logistic regressions were performed to identify the variables most significantly associated with in-hospital mortality.Results: The in-hospital mortality rate was 60.5%. Compared to survivors, non-survivors more often presented with pressure sores (P=0.005) and lymphopenia (P< 0.001), were more often treated with invasive mechanical ventilation (P< 0.001), and less often underwent geriatric assessment (P< 0.001). Non-survivors demonstrated higher mean levels of C-reactive protein, and lower mean values of serum cholesterol, triglycerides, total protein, and albumin (P< 0.001 for all comparisons). On multivariate analysis, the following variables were most significantly associated with in-hospital mortality in the entire cohort: the presence of pressure sores (odds ratio [OR], 4.34; 95% confidence interval [CI], 1.68– 11.48; P=0.003) and lymphopenia (OR, 4.09; 95% CI, 1.51– 11.08; P=0.006), and serum cholesterol (OR, 0.98; 95% CI, 0.96– 0.99; P=0.003).Conclusion: Among elderly acutely ill patients who initiated NGT feeding during hospitalization, in-hospital mortality was extremely high. The factors most strongly associated with in-hospital mortality were the presence of pressure sores and lymphopenia, and lower serum cholesterol levels. These findings may provide useful prognostic information for decision-making regarding initiation of NGT feeding in elderly hospitalized patients.Keywords: aging, enteral feeding, hospitalization, prognosis
