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    Differential Impact of Malnutrition on Health Outcomes Among Indigenous and Non-Indigenous Adults Admitted to Hospital in Regional AustraliaA Prospective Cohort Study

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    Author
    Morris, N; Stewart, S; Riley, M; Maguire, G
    Date
    2018-05-01
    Source Title
    Nutrients
    Publisher
    MDPI
    University of Melbourne Author/s
    Maguire, Graeme; Morris, Natasha
    Affiliation
    Nursing
    Medicine and Radiology
    Metadata
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    Document Type
    Journal Article
    Citations
    Morris, N., Stewart, S., Riley, M. & Maguire, G. (2018). Differential Impact of Malnutrition on Health Outcomes Among Indigenous and Non-Indigenous Adults Admitted to Hospital in Regional AustraliaA Prospective Cohort Study. NUTRIENTS, 10 (5), https://doi.org/10.3390/nu10050644.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255135
    DOI
    10.3390/nu10050644
    Abstract
    The burden of malnutrition in Indigenous people is a major health priority and this study's aims are to understand health outcomes among Indigenous and non-Indigenous patients. This cohort study includes 608 medical inpatients in three regional hospitals. Participants were screened for malnutrition using the Subjective Global Assessment tool. Hospital length of stay, discharge destination, 30-day and six-month hospital readmission and survival were measured. Although no significant difference was observed between Indigenous participants who were malnourished or nourished (p = 0.120), malnourished Indigenous participants were more likely to be readmitted back into hospital within 30 days (Relative Risk (RR) 1.53, 95% CI 1.19⁻1.97, p = 0.002) and six months (RR 1.40, 95% Confidence Interval (CI) 1.05⁻1.88, p = 0.018), and less likely to be alive at six months (RR 1.63, 95% CI 1.20⁻2.21, p = 0.015) than non-Indigenous participants. Malnutrition was associated with higher mortality (Hazards Ratio (HR) 3.32, 95% CI 1.87⁻5.89, p < 0.001) for all participants, and independent predictors for six-month mortality included being malnourished (HR 2.10, 95% CI 1.16⁻3.79, p = 0.014), advanced age (HR 1.04, 95% CI 1.02⁻1.06, p = 0.001), increased acute disease severity (Acute Physiology and Chronic Health Evaluation score, HR 1.03, 95% CI 1.01⁻1.05, p = 0.002) and higher chronic disease index (Charlson Comorbidity Index, HR 1.36, 95% CI 1.16⁻3.79, p = 0.014). Malnutrition in regional Australia is associated with increased healthcare utilization and decreased survival. New approaches to malnutrition-risk screening, increased dietetic resourcing and nutrition programs to proactively identify and address malnutrition in this context are urgently required.

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