BACKGROUND & AIMS: The literature regarding enteral nutrition and mortality in older frail people is limited and still conflicting. Moreover, the potential role of comprehensive geriatric assessment is poorly explored. We therefore aimed to investigate whether the Multidimensional Prognostic Index (MPI), an established tool that assesses measures of frailty and predicts mortality, may help physicians in identifying patients in whom ETF (enteral tube feeding) is effective in terms of reduced mortality. METHODS: Observational, longitudinal, multicenter study with one year of follow-up. Data regarding ETF were recorded through medical records. A standardized comprehensive geriatric assessment was used to calculate the MPI. Participants were divided in low (MPI-1), moderate (MPI-2) or severe (MPI-3) risk of mortality. Data regarding mortality were recorded through administrative information. RESULTS: 1064 patients were included, with 79 (13 in MPI 1-2 and 66 in MPI-3 class) receiving ETF. In multivariable analysis, patients receiving ETF experienced a higher risk of death (odds ratio, OR = 2.00; 95% confidence intervals, CI: 1.19-3.38). However, after stratifying for their MPI at admission, mortality was higher in MPI-3 class patients (OR = 2.03; 95%CI: 1.09-3.76), but not in MPI 1-2 class patients (OR = 1.51; 95%CI: 0.44-5.25). The use of propensity score confirmed these findings. CONCLUSIONS: ETF is associated with a higher risk of death. However, this is limited to more frail patients, suggesting the importance of the MPI in the prognostic evaluation of ETF.

1st Faculty of Medicine Charles University Prague Czech Republic

Ageing Clinical Research Dpt Medicine 2 University Hospital of Cologne Cologne Germany

Department of Clinical Pharmacology College of Medicine and Public Health Flinders University and Flinders Medical Centre Adelaide Australia

Department of Geriatric Care Orthogeriatrics and Rehabilitation Geriatric Unit E O Galliera Hospital Genova Italy

Department of Geriatric Care Orthogeriatrics and Rehabilitation Geriatric Unit E O Galliera Hospital Genova Italy; Azienda ULSS 3 Serenissima Primary Care Department District 3 Venice Italy

Department of Geriatric Care Orthogeriatrics and Rehabilitation Geriatric Unit E O Galliera Hospital Genova Italy; Department of Interdisciplinary Medicine 'Aldo Moro' University of Bari Italy

Geriatrics Department University Hospital Poitiers France

Geriatrics Unit AULSS 6 Euganea San Antonio Hospital Padova Italy

Geriatrics Unit IRCCS CSS San Giovanni Rotondo Italy

Scientific Coordination Unit E O Galliera Hospital Genova Italy

Section of Geriatric Medicine Erasmus University Medical Center Rotterdam the Netherlands

Servicio de Geriatría Hospital Universitario Ramón y Cajal Madrid Spain

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