The cause of anorexia and proportion of its recovery in older adults without underlying disease: Results of a retrospective study


Autoři: Nobuyuki Maki aff001;  Eiji Nakatani aff002;  Toshiyuki Ojima aff004;  Tomoka Nagashima aff005;  Takane Harada aff001;  Fumiko Koike aff005;  Naoki Tosaka aff001;  Hiroshi Yoshida aff001;  Toshio Shimada aff006
Působiště autorů: Department of Emergency Medicine, Shizuoka General Hospital, Shizuoka City, Shizuoka, Japan aff001;  Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Shizuoka City, Shizuoka, Japan aff002;  Division of Medical Statistics, Translational Research Center for Medical Innovation on Foundation for Biomedical Research and Innovation at Kobe, Kobe City, Hyogo, Japan aff003;  Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan aff004;  Community Medicine Network Center, Shizuoka General Hospital, Shizuoka City, Shizuoka, Japan aff005;  Clinical Research Center, Shizuoka General Hospital, Shizuoka City, Shizuoka, Japan aff006
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224354

Souhrn

Aim

It is difficult to determine whether or not end-of-life care is necessary for frail older adults complaining of anorexia without underlying disease, such as cancer or organ failure. The main reason for this is the lack of the specification of the anorexia cause and no understanding of the cause-providing factor and the prognostic factor. This study aimed to clarify the cause of anorexia, and the determinant of the cause and recovery from anorexia.

Methods

Retrospective chart reviews were conducted on patients with anorexia without an underlying disease who were aged ≥65 years and visited the emergency department of a single tertiary care center between 2016 and 2017. Patient characteristics at hospital visit, the cause of anorexia, and diagnostic modalities were summarized. The diagnosis-providing rate, recovery rate, and the association between them were analyzed.

Results

Eighty-three patients (mean age 82.3 years; 50.6% male) were investigated. In 67 patients (81%), the causes of anorexia were identified, including 18 patients (22%) with infection, 13 (16%) with benign gastrointestinal diseases, and 7 (8%) with cardiovascular diseases. In 16 patients (19%), the causes of anorexia were not identified despite examinations. The modality that most contributed to diagnosis was plain computed tomography followed by blood tests. The value regarding information in history-taking and physical examinations was limited. Sixty-five patients (78%) recovered. Only 73% of patients with a definite cause recovered; all patients with an unknown cause recovered.

Conclusions

Older adults with anorexia are not always at the end of life, and efforts to identify the cause are crucial. Moreover, it is vital to realize the limitations associated with the treatment of infections and cardiovascular diseases.

Klíčová slova:

Anorexia nervosa – Cancer detection and diagnosis – Cancer treatment – Computed axial tomography – Critical care and emergency medicine – Diagnostic medicine – Elderly – Prognosis


Zdroje

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2019 Číslo 10