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Hypophosphatemia as a sign of malnutrition in older hospitalized patients

European Journal of Clinical Nutrition volume 73, pages 634–636 (2019)Cite this article

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Abstract

The relationship between hypophosphatemia (HP) and malnutrition in older hospitalized patients has received little attention. We sought to investigate this association among this population. The study participants were consecutively admitted to a geriatric acute care ward in six hospitals. Malnutrition screening was conducted by Mini Nutritional Assessment-Short Form. Patients were divided into two groups according to serum phosphate: HP (<0.68 mmol/l) and non-HP groups (>0.68 mmol/l). Of 335 participants, 7% of subjects had HP. Malnutrition or nutritional risk was present in 86 and 56% of participants with and without HP, respectively (P = 0.003). The analysis indicated 9.8, 86.4, 97.9 and 44.0% sensitivity, positive predictive value, specificity and negative predictive value of HP with regard to malnutrition, respectively. This study demonstrated that HP in older hospitalized patients is associated with malnutrition and may be used as an indicator of nutritional risk. Contrary, normal serum phosphate does not exclude being at nutritional risk.

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References

  1. Kagansky N, Levy S, Koren-Morag N, Berger D, Knobler H. Hypophosphataemia in old patients is associated with the refeeding syndrome and reduced survival. J Intern Med Suppl. 2005;257:461–8.

    Article  CAS  Google Scholar 

  2. Sumukadas D, Jenkinson F, Witham MD. Associations and consequences of hypophosphataemia in older hospitalised women. Age Ageing. 2009;38:112–5.

    Article  Google Scholar 

  3. Rady HI, Khalek MKA. Prevalence and risk factors of hypophosphatemia in pediatric intensive care unit. J Anesth Crit Care Open Access. 2014;1:00033.

  4. Rio A, Whelan K, Goff L, Reidlinger DP, Smeeton N. Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study. BMJ Open. 2013;3e002173.

  5. Slee A, Birch D, Stokoe D. A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients. Clin Nutr. 2015;34:296–301.

    Article  Google Scholar 

  6. Pourhassan M, Cuvelier I, Gehrke I, Marburger C, Modreker MK, Volkert D, et al. Risk factors of refeeding syndrome in malnourished older hospitalized patients. Clin Nutr. 2017;37:1354–9.

    Article  Google Scholar 

  7. Qureshi AR, Alvestrand A, Divino-Filho JC, Gutierrez A, Heimburger O, Lindholm B, et al. Inflammation, malnutrition, and cardiac disease as predictors of mortality in hemodialysis patients. J Am Soc Nephrol: Jasn. 2002;13(Suppl 1):S28–36.

    PubMed  Google Scholar 

  8. Pourhassan M, Cuvelier I, Gehrke I, Marburger C, Modreker MK, Volkert D, et al. Prevalence of risk factors for the refeeding syndrome in older hospitalized patients. J Nutr Health Aging. 2018;22:321–7.

    Article  CAS  Google Scholar 

  9. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41.

    Article  CAS  Google Scholar 

  10. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56:M366–72.

    Article  CAS  Google Scholar 

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Author contributions

The study was designed by MP and RW. All authors contributed to the study idea and to the writing of the manuscript.

Funding

The study received no financial support.

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Authors and Affiliations

  1. Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität, Bochum, Germany

    Maryam Pourhassan & Rainer Wirth

  2. Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität, Kiel, Germany

    Manfred James Müller

  3. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany

    Dorothee Volkert

Authors
  1. Maryam Pourhassan
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  2. Manfred James Müller
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  3. Dorothee Volkert
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  4. Rainer Wirth
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Correspondence to Maryam Pourhassan.

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The authors declare that they have no conflict of interest.

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Pourhassan, M., Müller, M.J., Volkert, D. et al. Hypophosphatemia as a sign of malnutrition in older hospitalized patients. Eur J Clin Nutr 73, 634–636 (2019). https://doi.org/10.1038/s41430-018-0251-6

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  • DOI: https://doi.org/10.1038/s41430-018-0251-6

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