ABSTRACT
Body mass index (BMI) is an indicator for nutritional status which correlates with mortality. Studies in the past indicated that undernutrition was one of the major nutritional problems in elderly Thais especially in the rural area. The objective of this study is to determine the BMI of the elderly who live in rural areas of central Thailand. Random sampling of volunteers age > 60 years in 3 districts of Samut Songkram and Rajaburi provinces was done. One hundred and ninety-three elderly people, 77 men and 116 women, age 60-87 years old, were included in the study. BMI of male and female participants was 22.76 + 3.81 and 24.51+ 3.94 kg/m2 respectively. Women had significantly higher BMI than men. When used a BMI of <18.5 kg/m2 as cut-off point, 13.0% of male and 6.9% of female were suffering from under-nutrition. However, grade III malnutrition was found in only 1.5% of the participants of the study. In contrary, overweight and obesity was found 20.8% and 2.6% in male subjects and 33.6% and 11.2% in female subjects respectively. The prevalence of over-nutrition has increased during the past decade. A survey of over-nutrition related diseases is required and further surveillance in this population is essential to verify the impact of increasing BMI on morbidity and mortality in elderly people.
ABSTRACT
Introduction : Central access is important for parenteral nutrition, chemotherapy, some kinds of drugs. Selection of catheter and method of access are also important to ensure that Patients are safe from complications. PICC line (Peripherally Inserted Central Catheter) is made from polyurethane, and is designed for percutaneous insertion through superior vena cava. Methods : We have studied and used the PICC line with patients who need parenteral nutrition or long-term intravenous fluid application in Siriraj Hospital since November 1995. Results : A total of 35 patients received a PICC line, 23 males and 12 females. The average age was 53.6 years. Indication for central access was parenteral nutrition (28 patients) and for longterm IV fluid (7 patients). We used the pericubital fossa vein in 32 patients and the femoral vein in three patients. The methods of insertion were percutaneous puncture in 24 patients, direct puncture in one patient, and venesection with 10 patients. The PICC line can be use for a maximum of 40 days, but 18.5 days on average. At the time of this report, three patients were continuing the use of PICC lines. We found only one accidenetal arterial puncture at the cubital fossa, and no other serious complication. Reasons for removal were cure in 13 patients, clotting in three patients, phleditis in 10 patients, accidental removal in two patients and death from other problems in four patients, but no cases of infection at the tip of the catheter. With regard to nursing care, a PICC line should be filled with fluid at all times, and care should be taken not to draw the blood back and that there is no unnecarrary flexing of the elbow. Conclusion : From this preliminary study, we have shown that a PICC line, made from polyurethane, can be used with patients who need parenteral nutrition, intravenous drugs, or long-term IV fluid for at least 17 days without any problems. The method of insertion for a PICC line is more superior than the conventional method in the view of low risk of anatomical complication.