Impacts of an ICU visit and Number of Daily Medications on Five Year Weight Change

and Self-Reported Health in Patients Surveyed for Nutrition Day 2017 at LSCVAMC
Cheyenne Tate1,2
BACKGROUND 1-Dietetic Intern, Louis Stokes Cleveland VA Medical Center, Ohio 2-Gradutate Student, CWRU
FIGURE 3: COMPARISON OF MEAN % WEIGHT LOSS BASED ON ICU VISIT DURING
NUTRITION DAY 2017 AT LSCVAMC
• Nutrition Day1- an international tool to assess malnutrition, track TABLE 1: CHARACTERISTICS OF PATIENTS RECRUITED
0.02
trends and make comparisons in hospitalized patients. AT LSCVAMC FOR NUTRITION DAY 2017 % Weight Loss
No ICU N=25 ICU Stay N=2
• Several years of Nutrition Day information has already provided Characteristic N Measured Mean ± SD or n % 0.39
evidence showing underfeeding is a concern for ICU patients2and BMI 29 30.2 ± 6.6
that an ICU admission is a risk factor for malnutrition. Age 28 68 ±8.9
0 0.05 0.1 0.15 0.2 0.25 0.3 0.35 0.4 0.45
• A growing phenomenon is polypharmacy (>5 medications/daily) % Weight Change in Five Years 27 0.9 ±15.8
RESULTS
which is linked with increased overall mortality risk and Average Percent Weight Gain In 11 12.9 ± 9.9
• The average age of participants was 68 ±8.9 years.
decreased functional status3,4,5 Patients that Gained Weight
• The average BMI of participants was 30.2 ±6.6.
HYPOTHESES: Average Percent Weight Loss in 14 -11.8 ± 9.9 • Patients who visited the ICU had higher mean percent weight change
1. Patients who have visited the ICU will have significant weight Patients that Lost Weight in 5 years (0.39%) than those who did not (0.02%), however this was
change in the past 5 years Gender - Male 29 27 (93% ) not significant (p=0.52).
2. The number of daily medications a patient is taking relates to ICU Visit During Admission 29 • Patients taking 3-5 home medications daily most commonly reported
their reported well-being. Yes 2 (6%) their health as “fair” (57%) Patients taking >5 home medications
No 27 (93%)
daily, had equal responses for “fair” (38%) and “good” (33%). These
Number of Home Medications Daily 28
METHODS results were not significant (p=0.46).
None 0 (0%)
• Cross-sectional observational study 1-2 0 (0%)
• Health and nutrition data was collected using the Nutrition Day 3-5 7 (25%) DISCUSSION
template from 29 patients on inpatient wards at Louis Stokes >5 21 (75%) • Hypothesis 1: Inconclusive, unable to achieve significance.
Cleveland VA Medical Center. Self-Reported Health 28 • Only 2 patients visited the ICU. This impaired the ability to compare
• Data was sourced from electronic medical record review and Very Poor 1 (3%) groups. When assessing % weight change, patients who gained weight
patient-completed surveys.
Poor 5 (17%) and those who lost weight cancelled each other out.
• Exclusion Criteria: under the age of 18, displaying signs of
Fair 12 (42%) • Hypothesis 2: Inconclusive, unable to achieve significance.
cognitive impairment, non-English speaking, admitted and
Good 10 (35%) • Results were contrary to our hypothesis. Individuals taking greater
Very Good 0 (0%) than five home medications rated their health equally as “fair” or
discharged same-day or inability/unwillingness to consent
“good”. However, 0 participants in two of the categories: “none” and
FIGURE 2: COMPARISON OF NUMBER OF HOME MEDICATIONS TAKEN PER DAY AND
Continuous Variables such as descriptive statistics and % weight “1-2”, this limited our ability to compare groups.
SELF-REPORTED HEALTH IN PATIENTS SURVEYED FOR NUTRITION DAY 2017 AT LSCVAMC
change were expressed through mean and SD
9
• Moving forward: The study should be conducted again at LSCVAMC,
Categorical Variables such as previous ICU admission, self-reported but with a larger sample size to achieve significance.
8
health, number of home medications were reported as n and %
7 Continued participation in Nutrition Day is imperative to remedy
NUMBER OF PATIENTS

Variables Analysis:
6 malnutrition in the hospitalized population
References:
5
• An independent t-test was used to determine if % weight
1. International office Vienna.What Is Nutrition Day?nutritionDay worldwide.https://www.nutritionday.org/en/about-nday/what-is-nutritionday/index.html. Published May 8, 2017.Accessed October 28, 2017.
Number of Medications 2. Bendavid I, Singer P, Theilla M, Themessl-Huber M, Sulz I, Mouhieddine M, Schuh C, Mora B, Hiesmayr M.NutritionDay ICU: A 7 year worldwide prevalence study of nutrition practice in intensive careClin
Nutr. 2016 Aug 9. pii: S0261-5614(16)30178-9. doi: 10.1016/j.clnu.2016.07.012. [Epub ahead of print]
4
change differed in patients that had been admitted to the ICU. 3. Wang R, Chen L, Fan L, et al. Incidence and Effects of Polypharmacy on Clinical Outcome among Patients Aged 80 +: A Five-Year Follow-Up Study. Pietropaolo M, ed. PLoS ONE. 2015;10(11):e0142123.
doi:10.1371/journal.pone.0142123.
3 Zero 2-3 4. Ziere G, Dieleman JP, Hofman A, Pols HA, van der Cammen TJ, Stricker BH. Polypharmacy and falls in the middle age and elderly population. Br J Clin Pharmacol 2006;61: 218–223. pmid:16433876

• A chi-square test was used to assess if the number of daily 5. Maher RL, Hanlon JT, Hajjar ER. Clinical Consequences of Polypharmacy in Elderly. Expert opinion on drug safety. 2014;13(1):10.1517/14740338.2013.827660. doi:10.1517/14740338.2013.827660.
1)

2
• home medications a patient is on relates to reported well-being. 3-5 >5
Acknowledgements
The contents do not represent the views of the U.S. Department of Veterans Affairs or the United
1
• Participants with missing data were retained in the data set and States Government. This material is the result of work supported with resources and the use of
0
included in pairwise analyses. facilities at the Louis Stokes Cleveland VA Medical Center
Very Poor Poor Fair Good Very Good
1)