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  4. Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury

Impact of malnutrition on mortality and neurological recovery of older patients with spinal cord injury

Scientific Reports, 2024 · DOI: 10.1038/s41598-024-56527-y · Published: March 7, 2024

Spinal Cord InjuryAgingPublic Health

Simple Explanation

This study explores how malnutrition affects older adults (65+) who have suffered a spinal cord injury in their neck. Researchers assessed the nutritional health of almost 800 patients and tracked their recovery. The study found that patients with poor nutrition had a higher risk of dying within a year, shorter overall survival, less improvement in their neurological condition, and were less independent in their daily activities. The researchers suggest that assessing the nutritional status of older patients with spinal cord injuries is crucial for improving their outcomes.

Study Duration
2010 to 2020
Participants
789 patients aged ≥ 65 years with traumatic cervical SCI
Evidence Level
Not specified

Key Findings

  • 1
    6% of older patients with cervical SCI had major nutrition-related risks based on the Geriatric Nutritional Risk Index (GNRI).
  • 2
    Patients with major nutrition-related risks had a significantly higher 1-year mortality rate compared to matched controls (23.4% vs. 8.5%, p = 0.019).
  • 3
    Matched controls had a higher proportion of patients with neurological improvement of at least one AIS grade compared to patients with major nutrition-related risk (57.1% vs. 34.5%, p = 0.039).

Research Summary

This retrospective cohort study established malnutrition’s impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). In conclusion, 6% of older patients with cervical SCI had major nutrition-related risks; they showed a significantly higher 1 year mortality rate, shorter survival time, poorer neurological improvement, and lower ADL at 1 year post-injury than matched controls. Therefore, assessing nutrition-related risk for older patients with SCI, as well as a multidisciplinary approach with long-term follow-up for such patients with nutrition-related risk, will be essential to decrease the mortality rate and improve neurological recovery and ADL.

Practical Implications

Nutritional Assessment

Regularly assess the nutritional status of older SCI patients using tools like the GNRI to identify and address malnutrition early.

Multidisciplinary Approach

Implement a multidisciplinary approach involving physicians, nutritionists, and rehabilitation specialists to optimize patient care.

Long-Term Follow-Up

Provide long-term follow-up care to monitor and manage the nutritional needs of older SCI patients to improve their outcomes.

Study Limitations

  • 1
    Retrospective data collection
  • 2
    Study population included only Japanese patients and was heterogeneous
  • 3
    Lack of evaluation of nutritional intervention

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