4 research outputs found

    Neck circumference is associated with nutritional status in elderly nursing home residents

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    Objectives: Anthropometry is an easy and noninvasive method to evaluate nutritional status in institutionalized elderly people who are often bedridden. The aim of this study was to investigate the relationship between the neck circumference (NC) and nutritional status of elderly nursing home residents and to find cutoff points for NC size to identify individuals at risk of malnutrition. Methods: A cross-sectional study was developed with data collected from 352 elderly people living in five public nursing homes. Different anthropometric measures and the Mini Nutritional Assessment (MNA) were used to determine nutritional status. Receiver operating characteristic (ROC) curves were built for each anthropometric variable to determine their sensitivity and specificity for predicting the risk of malnutrition according to the MNA. Results: The mean age of the participants (59% females) was 83 years old. In total, 48.3% of women and 45.5% of men were at risk of malnutrition according to their MNA scores. All anthropometric measurements were highly intercorrelated in both men and women, indicating a high degree of collinearity. Bootstrapped linear regression was used to assess the strength of the association between an individuals’ nutritional status and their anthropometric parameters. Calf circumference and NC presented the best predictive value with the highest sensitivity for diagnosing the risk of malnutrition in both institutionalized elderly men and women. The best cutoff points of NC to identify elderly nursing home residents at risk of malnutrition were 35.2 cm for females and 37.8 cm for males. Conclusions: NC is associated with other classical anthropometric parameters and malnutrition status in elderly people living in nursing homes

    Masseter muscle thickness measured by ultrasound as a possible link with sarcopenia, malnutrition and dependence in nursing homes

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    Sarcopenia is a progressive and generalized loss of skeletal muscle mass and strength. It is frequently associated with malnutrition and dependence in nursing homes. Masticatory muscle strength could be the link between sarcopenia, malnutrition and dependence. We aimed to study the relation between sarcopenia, malnutrition and dependence with masseter muscle thickness measured by ultrasound. A cross-sectional study was realized, with 464 patients from 3 public nursing homes in Zaragoza (Spain). The diagnosis of sarcopenia was assessed according to the EuropeanWorking Group on Sarcopenia in Older People 2 criteria, malnutrition by the Mini Nutritional Assessment (MNA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria and functional capacity by the Barhel Index and the texture diet. Masseter muscle thickness (MMT) was measured by ultrasound. The median age was 84.7 years, and 70% of the participants were women. Sarcopenia was confirmed in 39.2% of patients, malnutrition in 26.5% (risk 47.8%), total dependence in 37.9% and diet texture was modified in 44.6%. By logistic regression, once the model was adjusted for age, sex, Barthel index and texture diet, our analyses indicated that each 1 mm decrease in MMT increased the risk of sarcopenia by ~57% (OR: 0.43), the risk of malnutrition by MNA by ~63% (OR: 0.37) and the risk of malnutrition by GLIM by ~34% (OR: 0.66). We found that MMT was reduced in sarcopenic, malnourished and dependent patients, and it could be the common point of a vicious cycle between sarcopenia and malnutrition. Further studies are needed to establish causality. © 2021 by the authors

    The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

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    The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery

    The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

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    AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease
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