RACIAL AND GENDER DISPARITIES IN ORAL NUTRITIONAL SUPPLEMENTATION AMONG ADULT COVID-19 PATIENTS
Gastroenterology
; 162(7):S-462-S-463, 2022.
Article
in English
| EMBASE | ID: covidwho-1967307
ABSTRACT
Background:
In COVID-19, hospitalized patients are at high risk for malnutrition upon admission due to intense catabolic processes coupled with comorbidities. Malnutrition has been strongly linked to adverse health economic outcomes in the hospital setting and society guidelines recommend early intervention to preserve lean body mass and mitigate adverse health economic outcomes. We have previously reported that malnourished African Americans (P=0.014) and females (P<0.001) were less likely to receive oral nutrition supplement (ONS) orders in a cohort of 8,713 adult malnourished patients hospitalized in a tertiary care center over a one-year period. We determined if there were disparities in the ordering of ONS in hospitalized COVID-19 patients during the height of the pandemic in 2020.Methods:
This is a retrospective cohort study consisting of 3,431 COVID-19 adult (18 years and older) inpatient encounters at five Johns Hopkins affiliated hospitals between March 1, 2020, and December 3, 2020. Patients diagnosed with COVID-19 were identified as those who were assigned an ICD-10 billing code of U07.1 for COVID-19. Malnourishment among patients was identified as those who risk screen positive upon admission by use of the malnutrition universal screening tool (MUST) and confirmed by registered dietitians. Patient feeding status was identified as those who had a record of diet orders placed. Patient data was derived from JH-CROWN The COVID-19 Precision Medicine Analytics Platform (PMAP) Registry and extracted using Python 3, version 3.7.5, kernel in JupyerLab, version 1.1.4. Statistics were conducted with SAS (version 9.4) software to examine the effect of malnutrition on mortality and hospital length of stay among COVID-19 inpatient encounters while accounting for possible covariates.Results:
Older patients were more likely to have received ONS (P<0.001) (Table 1). Patients with diabetes (P=0.0410), hypertension (P=0.0296), COPD (P=0.0013), and malnutrition (P=0.0106) were also more likely to have received ONS (Table 1). Males were more likely to receive ONS than females (0.0089) (Table 1). Whites were more likely to receive ONS than Blacks, Asian, or Other races (P=0.0037) (Table 1). In the logistic regression model, females (P=0.0079), blacks (P=0.0026), and Other races (P=0.0143) were less likely to receive ONS (Table 2). Patients with diabetes were more likely to receive ONS (P=0.0255) (Table 2). Older (P=0.059) patients and those with COPD (P=0.0709) are suggestive of an increased likelihood of receiving ONS (Table 2).Conclusions:
Gender and race disparities exist in the ordering of ONS was in a robust cohort of COVID-19 adult inpatients from five US hospitals. Further studies should be conducted to determine if there is a widespread racial and gender bias in the ordering of ONS.(Table Presented)(Table Presented)
nutrition supplement; adult; Black person; Caucasian; chronic obstructive lung disease; cohort analysis; conference abstract; controlled study; coronavirus disease 2019; diabetic patient; diet supplementation; dietitian; feeding; female; gender bias; hospital patient; human; hypertension; ICD-10; length of stay; major clinical study; male; Malnutrition Universal Screening Tool; mortality; multicenter study; pandemic; patient coding; personalized medicine; retrospective study; software
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Gastroenterology
Year:
2022
Document Type:
Article
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