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Epidemiology

Association between hospitalization-related outcomes, dynapenia and body mass index: The Glisten Study

European Journal of Clinical Nutrition volume 73, pages 743–750 (2019)Cite this article

Subjects

Abstract

Objective

To compare the prognostic value of dynapenia, as evaluated by handgrip, and body mass index (BMI) on length of stay (LOS), days of bed rest, and other hospitalization-related outcomes in a population of older adults admitted to 12 italian acute care divisions.

Methods

Data on age, weight, BMI, comorbidities, ADL, physical activity level, muscle strength, were recorded at hospital admission. LOS, days of bed rest, intrahospital falls, and discharge destination were also recorded during the hospitalization. Subjects with BMI <18.5 kg/m2 were classified as underweight, subjects with BMI 18.5–24.9 as normal weight, subjects with BMI ≥25 as overweight-obese.

Results

A total of 634 patients, mean age 80.8 ± 6.7 years and 49.4% women, were included in the analysis. Overall dynapenic subjects (D) showed a longer period of LOS and bed rest compared with non-dynapenic (ND). When the study population was divided according to BMI categories, underweight (UW), normal weight (NW), and overweight-obese (OW-OB), no significant differences were observed in hospital LOS and days of bed rest. When analysis of covariance was used to determine the difference of LOS across handgrip/BMI groups, D/OW-OB and D/UW subjects showed significantly longer LOS (11.32 and 10.96 days, both p 0.05) compared to ND/NW subjects (7.69 days), even when controlling for age, gender, baseline ADL, cause of hospitalization and comorbidity. After controlling for the same confounding factors, D/OW-OB, D/NW and D/UW subjects showed significantly longer bed rest (4.7, 4.56, and 4.05 days, respectively, all p 0.05, but D/OW-OB p 0.01) compared to ND/NW subjects (1.59 days).

Conclusion

In our study population, LOS is longer in D/UW and D/OW-OB compared to ND/NW subjects and days of bed rest are mainly influenced by dynapenia, and not by BMI class.

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Acknowledgements

The manuscript has been extensively revised by a medical writer and native English speaker, Prof Mark J Newman.

Glisten Study Group Investigators

Gloria Brombo, Elisa Maietti, Beatrice Ortolani, Elisabetta Savino, Valeria Buttò, Alberto Fisichella, Elisa Carrarini, Mauro Zamboni, Maria Laura Di Meo, Francesco Orso, Flavia Sacco, Alessandra Bonfanti, Anna Paola Cerri, Marco Motta, Francesca Pittella, Sergio Fusco, Valeria Prestipino Giarritta, Luca Soraci, Luca Agosta, Lorenzo Marchese, Claudia Basile, Ilaria Fava, Paolo Salaris, Olga Catte, Maura Orru, Elena Ortolani, Anna Maria Martone, Sara Salini, Barbara Carrieri, Giuseppina dell’Aquila

Author information

Authors and Affiliations

  1. Department of Medicine, Geriatrics Division, Healthy Aging Center Verona, University of Verona, Verona, Italy

    Andrea P Rossi & Francesco Fantin

  2. Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy

    Pasquale Abete

  3. School of Medicine and Surgery, Italy Geriatric Unit, S. Gerardo Hospital, University of Milano-Bicocca, Monza, Italy

    Giuseppe Bellelli

  4. Geriatrics and Bone Metabolism Disease Department, Citta’ della Salute e della Scienza-Molinette, Turin, Italy

    Mario Bo

  5. IRCCS-INRCA, Geriatria, Accettazione Geriatrica e Centro di ricerca per l’invecchiamento, Ancona, Italy

    Antonio Cherubini

  6. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    Francesco Corica

  7. Department of Experimental and Clinical Medicine, Research Unit of Medicine of Aging, University of Florence, Florence, Italy

    Mauro Di Bari

  8. Department of Geriatrics and Medicine, Geriatric Intensive Care Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Mauro Di Bari

  9. Department of Clinical and Experimental Medicine, Geriatric Rehabilitation Department, University of Parma, Parma, Italy

    Marcello Maggio

  10. Geriatrics Department. SS, Trinità ASL 8, Cagliari, Italy

    Giovanna Maria Manca

  11. Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Naples, Naples, Italy

    Maria Rosaria Rizzo

  12. Department of Medical Science, University of Ferrara, Ferrara, Italy

    Lara Bianchi & Stefano Volpato

  13. Department of Geriatrics, Neurosciences and Orthopaedics, Catholic University of the Sacred Heart, Rome, Italy

    Francesco Landi

  14. Department of Health Sciences, University of Milano Bicocca, Milano, Italy

    Alessandra Bonfanti, Anna Paola Cerri, Marco Motta & Francesca Pittella

  15. Monza Acute Geriatric Unit, S. Gerardo Hospital, Monza, Italy

    Alessandra Bonfanti, Anna Paola Cerri, Marco Motta & Francesca Pittella

  16. Dipartimento di Scienze Mediche, SCDU Geriatria e Malattie Metaboliche dell’Osso, Città della Salute e della Scienza, Molinette, Torino, Italy

    Luca Agosta & Lorenzo Marchese

  17. Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell’Invecchiamento, Seconda Università di Napoli, Napoli, Italy

    Ilaria Fava, Carla Coppola & Anna Maria Dalise

  18. UOC di Geriatria Ospedale SS, Trinità ASL 8 Cagliari, Cagliari, Italy

    Paolo Salaris, Olga Catte & Maura Orru

  19. Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy

    Barbara Carrieri & Giuseppina dell’Aquila

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  1. Andrea P Rossi
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Consortia

for the GLISTEN Group Investigators

  • Gloria Brombo
  • , Elisa Maietti
  • , Beatrice Ortolani
  • , Elisabetta Savino
  • , Valeria Buttò
  • , Alberto Fisichella
  • , Elisa Carrarini
  • , Mauro Zamboni
  • , Maria Laura Di Meo
  • , Francesco Orso
  • , Flavia Sacco
  • , Alessandra Bonfanti
  • , Anna Paola Cerri
  • , Marco Motta
  • , Francesca Pittella
  • , Sergio Fusco
  • , Valeria Prestipino Giarritta
  • , Luca Soraci
  • , Luca Agosta
  • , Lorenzo Marchese
  • , Claudia Basile
  • , Ilaria Fava
  • , Carla Coppola
  • , Anna Maria Dalise
  • , Paolo Salaris
  • , Olga Catte
  • , Maura Orru
  • , Elena Ortolani
  • , Anna Maria Martone
  • , Sara Salini
  • , Barbara Carrieri
  •  & Giuseppina dell’Aquila

Corresponding author

Correspondence to Andrea P Rossi.

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The authors declare that they have no conflict of interest.

Additional information

Members of the GLISTEN study group investigators appear above the reference.

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Rossi, A.P., Fantin, F., Abete, P. et al. Association between hospitalization-related outcomes, dynapenia and body mass index: The Glisten Study. Eur J Clin Nutr 73, 743–750 (2019). https://doi.org/10.1038/s41430-018-0184-0

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  • DOI: https://doi.org/10.1038/s41430-018-0184-0

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