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Master Thesis

Relations entre infections associées aux soins et dénutrition chez le patient âgé : étude quantitative rétrospective basée sur 263 patients de l'unité de court séjour gériatrique du centre hospitalier d'Orthez : implication du médecin traitant

Abstract : Background: Malnutrition is commonly found in the elderly. During institutionalizations, even hospitalizations, they have more infections than the rest of the population, making it a public health issue. Connections between healthcare associated infections (HAI) and malnutrition are seldom objectified or considered. Objective: To determine a link between malnutrition in the elderly and hai, in order to offer a medical and social strategy for primary prevention and improved healthcare. Material and method: We monitored 263 stays over a 6 month period, of elderly patients with a mean age of 85.4 years and admitted to the short term geriatric care unit. The reason and length of hospitalization, clinical and biological criteria of nutritional status, the outbreak of infections and their nature during the stay at the hospital, and their lifestyle, were all noted. Results: 22% of patients come from institutions. Malnutrition affect 80% of patients. 38% were moderately malnourished and 42% severely or deeply malnourished, while 36.5% are receiving oral nutritional supplements (ONS). Infection is the second reason for hospitalization. HAI affected 38.5% of patients. Institutionalization increases the relative risk (RR) to present HAI by 2.36, extending the length of stay by 1.81, and swallowing disorders by 1.83. Hypoalbuminemia starting from 34 g/l, then severe and/or intense (≤ 30 g/l), increases the risk of HAI, however a BMI < 21 doesn't. We keep the threshold value of 32 g/l below which the risk of hai is maximal. Conclusion: There is a link between malnutrition and HAI. We discuss the threshold of severe malnutrition proposed by the Haute Autorité de Santé (HAS) (French national authority for health). Albuminemia is the most reliable and simple characterization parameter in common practice. ONS remain insufficiently prescribed, and malnutrition is seldom considered. Outpatient treatment care is essential.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01201991
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, September 18, 2015 - 2:41:31 PM
Last modification on : Wednesday, August 23, 2017 - 4:30:46 PM
Long-term archiving on: : Tuesday, December 29, 2015 - 8:42:29 AM

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Nilton Jorge Rodrigues. Relations entre infections associées aux soins et dénutrition chez le patient âgé : étude quantitative rétrospective basée sur 263 patients de l'unité de court séjour gériatrique du centre hospitalier d'Orthez : implication du médecin traitant. Médecine humaine et pathologie. 2015. ⟨dumas-01201991⟩

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