Comparison of Mini Nutritional Assessment-Short and Long Form to predict all-cause mortality up to 7 years in geriatric outpatients.

BACKGROUND: We aimed to find out whether the Mini Nutritional Assessment-Short Form (MNA-SF) can predict mortality up to 7 years when compared with the Mini Nutritional Assessment-Long Form (MNA-LF) in geriatric outpatients. METHODS: This retrospective study was conducted in patients (≥65 years) who were admitted to the geriatric outpatient clinic of a university hospital. MNA-SF and MNA-LF results were available for all patients. Patients were grouped as normal nutrition status (score 12-14), at risk of malnutrition (score between 8 and 11), or malnourished (score ≤7) according to MNA-SF. Based on MNA-LF, patients had normal nutrition status (score ≥24), were at risk of malnutrition (score 17-23.5), or were malnourished (score <17). Survival of the patients was assessed retrospectively. RESULTS: The study included 209 patients (62.2% female). During the 7-year follow-up, 77 (36.8%) patients died. After adjusting for age, sex, and Charlson comorbidity index, MNA-SF was significantly associated with all-cause mortality during 6-month, 1-year, 3-year, 5-year, and 7-year follow-up time. MNA-LF was superior to MNA-SF to estimate 6-month (P = 0.004) and 1-year mortality (P = 0.031). There was no difference between MNA-SF and MNA-LF regarding 3-year, 5-year, and 7-year mortality. CONCLUSION: MNA-SF can predict short-term and long-term mortality in geriatric outpatients as well as MNA-LF. A cut-off value of 11, indicating risk of malnutrition according to MNA-SF, may be used for the risk estimation of 1-year, 3-year, and 5-year mortality. Therefore, this study highlights the importance of screening all geriatric outpatients for malnutrition and especially the risk of malnutrition for early intervention and treatment.

The effect of anticancer therapy on anti-hepatitis B antibody titres in patients with haematological malignancies and solid tumours.

OBJECTIVE: To investigate the effect of immunosuppressive anticancer therapy on titre levels of anti-hepatitis B surface antibodies (anti-HBs) in hepatitis B surface antigen (HBsAg) negative and anti-HBs positive patients with haematological malignancies or solid tumours. METHODS: This retrospective study reviewed the medical records of patients with haematological malignancies or solid tumours. Pretreatment HBsAg negative and anti-HBs positive patients were included in the analysis. Anti-hepatitis B core antibody status was used to evaluate vaccinated patients and those with resolved HBV infections. RESULTS: The medical records of 237 patients were reviewed retrospectively. The median anti-HBs titre decreased significantly after anticancer therapy compared with the pretreatment median anti-HBs titre in all patients (71 mIU/ml versus 57 mIU/ml). Anti-HBs titre decreased significantly in patients with haematological malignancies (70 mIU/m versus 37 mIU/ml) and in patients administered rituximab-based chemotherapy (67 mIU/ml versus 33 mIU/ml) following chemotherapy, whereas there was no significant change in patients with solid tumours. After chemotherapy, patients with low pretreatment anti-HBs titres (<100 mIU/ml) were more likely to become seronegative (<10 mIU/ml). CONCLUSION: High levels of anti-HBs may have a protective effect against the reactivation of HBV especially in patients with haematological malignancies who received immunosuppressive anticancer therapy.

Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults.

BACKGROUND: Malnutrition is a pitfall in older adults despite its high prevalence and serious consequences. There are various screening tests however, none of them have been validated for our country. In this study, we aimed to test the hypothesis that MNA (long form of MNA) and MNA-SF (short form of MNA) are applicable to screen malnutrition in Turkish geriatric patients. MATERIALS AND METHODS: Two hundred and thirty-six patients aged 65 years and over who were admitted to our geriatric medicine outpatient clinic were enrolled in the study. Four groups of data (anthropometric measurements, biochemical markers, three-day diet record and geriatric assessment scales) were recorded. Long and short forms of MNA test were performed. Two different geriatricians interpreted the patients' nutritional status with the aid of aforementioned data. Patients were divided into three groups which were patients with malnutrition, with malnutrition risk and well-nourished. Concordance between the two geriatricians' clinical assessment was analyzed by kappa statistics. Excellent concordance was found, therefore the first specialist's decisions were accepted as gold-standard. A third physician performed the long and short forms of MNA test. The concordance between the first clinician's assessment and MNA test results were compared subsequently. RESULTS: MNA and MNA-SF results were compared with first clinician's decision of malnutrition and kappa coefficients were 0.68 and 0.66, respectively. Sensitivity analysis indicated that MNA was 92% sensitive and 86% specific, whereas MNA-SF was 94% sensitive and 81% specific. CONCLUSION: MNA and MNA-SF are suitable for malnutrition screening in Turkish older adults.