The investigation of malnutrition and life quality’s relation with mortality in the patients who are 65 years old and above and are hospitilazed at the palliative care service

Abstract

Aims: Our study aims to determine the impact of malnutrition on the quality of life of elderly patients receiving palliative care and identify the factors influencing quality of life. Methods: The study included patients aged 65 and older who were admitted to the Kırıkkale University Medical Faculty Hospital Palliative Care Service between November 2019 and February 2020. Patients with a history of active malignancy, hospitalization within the past 3 months, severe dementia precluding obtaining written consent, and patients under 65 years of age were excluded. Scores obtained from the Mini Nutritional Assessment-Short Form (MNA-SF) were recorded, with scores of 12 or higher considered as normal nutrition. Those with scores below 12 were reevaluated for malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria, and those meeting any of the phenotypic and etiological criteria were considered malnourished. Malnutrition severity was reclassified according to the GLIM criteria. The 13-item OPQOLbrief questionnaire was used to evaluate their quality of life. The questionnaire was published in Turkish by Çalışkan et al. Each question was rated on a scale of 1-5, with “Strongly Disagree” scored as 1, “Disagree” as 2, “Undecided” as 3, “Agree” as 4, and “Strongly Agree” as 5. Results: The mean total MNA score was found to be statistically lower in patients classified as mild and severe malnutrition according to the GLIM classification compared to those without malnutrition (p<0.001). The rate of MNA scores between 12 and 14 in patients without malnutrition was higher than that of patients with mild and severe malnutrition, while the rate of scores between 8 and 11 was higher in patients with severe malnutrition. The rate of scores between 0 and 7 was higher in patients with mild and severe malnutrition (p<0.001). The mean total MNA (p<0.001) and QOL (p=0.021) scores were statistically lower in patients with malnutrition compared to those without malnutrition. The rate of MNA scores between 12 and 14 and between 8 and 11 was higher in patients without malnutrition, while the percentage of MNA scores between 0 and 7 was higher in patients with malnutrition. Conclusion: In the geriatric patient group, we believe that the GLIM criteria used in our study are more comprehensive and sensitive in detecting malnutrition in terms of phenotypic and etiological aspects through patient questioning.