The relationship of functional status, nutritional assessment, and severity of illness to in-hospital mortality
Thomas, D.R.; Kamel, H.; Azharrudin, M.; Ali, A.S.; Khan, A.; Javaid, U.; Morley, J.E.
Journal of Nutrition Health and Aging 9(3): 169-175
2005
ISSN/ISBN: 1279-7707 PMID: 15864397 Document Number: 584465
Background: Prediction of in-hospital mortality may direct hospital resources towards those patients most at risk. A number of single domain risk instruments have been developed, indicating that functional status, nutritional assessment, and severity of illness individually predict in-hospital mortality. The interaction among these predictors is less well described. Objective: To determine the relationship of functional status, nutritional assessment, and severity of illness to in-hospital mortality. Design, Setting, Subjects: Cohort study of 1712 consecutive admissions over a one year period to an Internal Medical Service at a tertiary university teaching hospital [USA; date not given]. Main Outcome Measures: Death during hospital admission. Results: Dependency in activities of daily living (OR=3.37, 95% CI 1.78 to 6.37, p=0.0002) and body mass index less than 20 (OR=2.38, 95% CI 1.20 to 4.74, p=0.01) predicted in-hospital mortality after adjusting for nutritional risk assessment, and severity of illness score. Conclusions: Impairment in functional status and low body mass index produce the best predictors of in-hospital mortality, after adjusting for nutritional risk and severity of illness score. Among these factors, functional impairment may be amenable to correction.