F Buntinx

Occurrence of malnutrition and associated factors in community-dwelling older adults: Those with a recent diagnosis of cancer are at higher risk

ObjectivesIn older adults, nutritional health is essential for good quality of life and living independently at home. Especially in cancer patients, malnutrition is common and known to complicate treatment. This study aims to evaluate the nutritional status and its associated factors in community-dwelling older adults with and without cancer.DesignThis is an observational study.SettingThis study focuses on older community-dwelling people.ParticipantsThis study included older people with and without cancer (≥70 years). Cancer patients included patients with a new diagnosis of breast, lung, prostate, or colorectal cancer.MeasurementsData collection included measures of nutritional status, quality of life, depression, fatigue, distress and functional status. We used multivariate logistic regression analysis to assess the association between personal characteristics and malnutrition.ResultsData were available for 657 people; 383 people without cancer and 274 with a cancer diagnosis. Overall, malnutrition was detected in 245 (37.5%) people; in cancer patients this was 66.1%. Multivariate analysis showed that having cancer (OR 14.4, 95% CI: 8.01 - 23.3), being male (OR 2.38, 95% CI: 1.49–3.70), having depression (OR 13.5, 95% CI: 6.02-30.0), distress (OR 2.60, 95% CI: 1.55–4.37) and impaired instrumental activities of daily living (IADL) (OR 2.63, 95% CI: 1.63–4.24) were associated with a higher risk of malnutrition.ConclusionThe prevalence of malnutrition in community-dwelling older people is high, particularly in patients with cancer. Benchmarking and routine screening of older patients may be helpful strategies to increase awareness of (risk of) malnutrition among professionals.

Ernstige infecties bij kinderen op een spoedgevallendienst in Vlaanderen: de invloed van klinische tekenen

Readily available demographic or clinical variables could be helpful in identifying children at higher risk of suffering a serious infection. We analysed for the first time in Flanders (Belgium) the data of 384 children at an emergency ward. Serious infections were defined as sepsis, pneumonia, meningitis, urinary tract infection, bacterial gastroenteritis, bronchiolitis and cellulitis. The clinical and demographic variables were registered prospectively. A multivariate analysis was performed using logistic regression analysis. The prevalence of a serious infection was 25%. The probability of a serious infection was highest for children under the age of one. The odds ratio for children 1-3 years was 0.34 (95% CI: 0.17-0.71), for 4-6 years 0.18 (95% CI: 0.07-0.45) and for 7-16 years 0.36 (0.15-0.87). Children referred to the emergency ward by another doctor had an odds ratio of 2.2 (95% CI: 1.1-4.1) for having a serious infection, compared to self-referred children. When the attending ward physician judged the child to be fairly or seriously ill at first impression, the odds ratio for a serious infection amounted to 3.8 (95% CI: 2.0-7.4) and to 11.7 (95% CI: 4.1-33.1) respectively. Age, referral and first impression of the attending ward physician are important criteria for identifying children at higher risk of having a serious infection in the emergency ward.