{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:52Z","timestamp":1786978312698,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T00:00:00Z","timestamp":1692489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We examine here the association between malnutrition risk and adverse health outcomes among older adult patients undergoing elective surgical procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study using linked clinical and administrative databases. Malnutrition risk was assessed prior to surgery, defined by unintentional weight loss and decreased food intake. We performed a logistic regression analysis of the primary outcome, a composite adverse outcome measure, including death, bleeding, pneumonia, and other surgical complications. We conducted Fine\u2010Gray proportional hazard regression analysis of hospital length of stay (LOS). We performed a generalized linear regression analysis of in\u2010hospital cost data. All regression analyses controlled for frailty, age, sex, surgical category, and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of a total of 3457 older adult elective surgical patients (65\u2013102 years), 310 (9.0%) screened positive for malnutrition risk. In multivariable regression analyses, malnutrition risk was associated with an increased risk of the composite adverse outcome (odds ratio [OR]\u2009=\u20091.74; 95% CI\u2009=\u20091.25\u20132.39), higher hospitalization costs (relative cost\u2009=\u20091.84; 95% CI\u2009=\u20091.59\u20132.13), and a decreased risk of discharge from the hospital (hazard ratio\u2009=\u20090.67; 95% CI\u2009=\u20090.59\u20130.77) compared with those who screened negative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older adult patients with malnutrition risk were at an increased risk of adverse surgical outcomes, had longer LOS in the hospital, and incurred higher costs of care. It is important to screen for malnutrition risk and refer older adults for dietetic consults prior to elective surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ncp.11043","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T20:57:20Z","timestamp":1692651440000},"page":"1045-1062","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Malnutrition risk, outcomes, and costs among older adults undergoing elective surgical procedures: A retrospective cohort study"],"prefix":"10.1002","volume":"38","author":[{"given":"Bill","family":"Le","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Flier","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry Western University London Ontario Canada"},{"name":"Lawson Health Sciences Research Institute London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Madill","sequence":"additional","affiliation":[{"name":"School of Food and Nutritional Sciences Brescia University College London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Joyes","sequence":"additional","affiliation":[{"name":"SouthWestern Academic Health Network London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Dawson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Wellington","sequence":"additional","affiliation":[{"name":"School of Food and Nutritional Sciences Brescia University College London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadia","family":"Adekunte","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davy","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry Western University London Ontario Canada"},{"name":"School of Medicine The Chinese University of Hong Kong Shenzhen China"},{"name":"Centre for Medical Evidence, Decision Integrity and Clinical Impact, Schulich School of Medicine and Dentistry Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6108-1105","authenticated-orcid":false,"given":"Ava","family":"John\u2010Baptiste","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry Western University London Ontario Canada"},{"name":"Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry Western University London Ontario Canada"},{"name":"Lawson Health Sciences Research Institute London Ontario Canada"},{"name":"Centre for Medical Evidence, Decision Integrity and Clinical Impact, Schulich School of Medicine and Dentistry Western University London Ontario Canada"},{"name":"Schulich Interfaculty Program in Public Health Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13072316"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2016.04.003"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2016.09.009"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607114567902"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.12927\/hcq.2018.25529"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607114566854"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12237"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs381"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000511698.41409.4a"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2015.47"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.01.021"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2006.077180"},{"key":"e_1_2_9_14_1","unstructured":"Government of Canada. 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