Prognostic Nutritional Index at admission As Predictor of Body Weight Loss and Swallowing Dysfunction at discharge in Older Adults Inpatients

Background: Older adult inpatients, diagnosing sarcopenia or frailty is determining procedures of mortality or outcomes, partly because body composition assessments measured by radiological modality such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), or dual-energy X-ray absorptiometry (DEXA) that must interfere social distances in COVID-19 circumstances. Hypotheses: Under such conditions, we hypothesized that: 1) prognostic nutritional index (PNI) is predictor of body weight (BW) change during hospitalization in older adult inpatients (pts) + 65 years old. 2) BW loss is associated with muscle depletion not only in legs but also swallowing muscles. Aims: To test our hypothesis that pts who showed BW loss at discharge must have impairment of swallowing capacity and poor outcome and that these pts must be predicted by low PNI score and to be target of nutritional interventions at admission, we have conducted this study. Methods: Participants was sequentially recruited to all inpatients. The exclusion criteria were: shorter stay in hospital. To measure swallowing capacities in recruited pts, Functional Oral Intake Scale (FIOS) and International Dysphagia Diet Standardization Initiative Functional Diet Scale (IDDSI-FDS) for scaling diet textures objectively were applied. Results: The recruited pts counted 95 cases. Body size and CCI of two groups were similar. PNI score at admission in group with BW loss was significantly smaller than in without group (39.0 vs. 43.6, p=0.040). BW loss group had swallowing dysfunction shown by FIOS and IDDS scores. The cutoff value of PNI among participants to predict BW loss at discharge was 40 determined by ROC curve analysis. Conclusions: PNI as surrogate biomarker seems to predict BW loss at discharge and swallowing dysfunction in older adult inpatients + 65 years. The cutoff value of PNI was determined 40.