Abstract：
There is an overlap between the risk factors causing low intake of water and low intake of nutrients, respectively. This study aims to explore the agreement between the assessment of malnutrition and the outcome of low-intake dehydration in a population of older hospitalized patients.
Patients ≥65 years old and hospitalized at the geriatric hospital ward were screened for eligibility within 96 h of admission. Dehydration was assessed with the calculated serum osmolarity ≥295 mmol/L (1.86 × (Na+ + K+) + 1.15 × glucose + urea + 14), and (risk of) malnutrition was assessed with NRS-2002 ≥ 3 points, MNA-SF ≤ 7 points, MNA-LF < 17, MUST ≥ 2 points, and GLIM after screening with NRS-2002 and MNA-LF. Follow-up data regarding exercise rehabilitation, readmissions, and mortality was collected 30 days after discharge. Statistics used were the Chi-squared test, Fishers-exact test, and Wilcoxon signed rank test.
A total of 114 patients (57% females) were included. Median age 85.5 (IQR 80; 89.25) years. A total of 49 (43%) were dehydrated. Fewer females were dehydrated (F: 42.9% vs. M: 67.7%, p = 0.013). The patients with osmolarity ≥295 mmol/L had a higher median weight (68.3 (IQR 58.5; 78.4) vs. 62 (IQR 51.8; 72.1), p = 0.021) and mid-up-arm circumference (27 (IQR 26; 30) vs. 25.5 (IQR 22.9; 28.3), p = 0.004). No significant difference was found in the prevalence of malnutrition between those with or without dehydration (NRS-2002; 70% vs. 81%, p = 0.174; MNA-SF: 23.1 vs. 23.2%, p = 1.0; MNA-LF: 37.1 vs. 30.2%, p = 0.644; MUST: 24.5 vs. 33.8%, p = 0.308; GLIM after screening with NRS-2002: 84.4 vs. 74.5%, p = 0.405, GLIM after screening with MNA-LF: 74.1 vs. 75.6%, p = 0.438). Kappa values varied around 0 and reflected low agreement. There were no differences in the follow-up data, between those who were normohydrated and those who were dehydrated.
We found low agreement between the assessment of malnutrition and low-intake dehydration in a population of older hospitalized patients. All geriatric patients should therefore be assessed for both conditions.
Patients ≥65 years old and hospitalized at the geriatric hospital ward were screened for eligibility within 96 h of admission. Dehydration was assessed with the calculated serum osmolarity ≥295 mmol/L (1.86 × (Na+ + K+) + 1.15 × glucose + urea + 14), and (risk of) malnutrition was assessed with NRS-2002 ≥ 3 points, MNA-SF ≤ 7 points, MNA-LF < 17, MUST ≥ 2 points, and GLIM after screening with NRS-2002 and MNA-LF. Follow-up data regarding exercise rehabilitation, readmissions, and mortality was collected 30 days after discharge. Statistics used were the Chi-squared test, Fishers-exact test, and Wilcoxon signed rank test.
A total of 114 patients (57% females) were included. Median age 85.5 (IQR 80; 89.25) years. A total of 49 (43%) were dehydrated. Fewer females were dehydrated (F: 42.9% vs. M: 67.7%, p = 0.013). The patients with osmolarity ≥295 mmol/L had a higher median weight (68.3 (IQR 58.5; 78.4) vs. 62 (IQR 51.8; 72.1), p = 0.021) and mid-up-arm circumference (27 (IQR 26; 30) vs. 25.5 (IQR 22.9; 28.3), p = 0.004). No significant difference was found in the prevalence of malnutrition between those with or without dehydration (NRS-2002; 70% vs. 81%, p = 0.174; MNA-SF: 23.1 vs. 23.2%, p = 1.0; MNA-LF: 37.1 vs. 30.2%, p = 0.644; MUST: 24.5 vs. 33.8%, p = 0.308; GLIM after screening with NRS-2002: 84.4 vs. 74.5%, p = 0.405, GLIM after screening with MNA-LF: 74.1 vs. 75.6%, p = 0.438). Kappa values varied around 0 and reflected low agreement. There were no differences in the follow-up data, between those who were normohydrated and those who were dehydrated.
We found low agreement between the assessment of malnutrition and low-intake dehydration in a population of older hospitalized patients. All geriatric patients should therefore be assessed for both conditions.
摘要：
目的：导致水摄入量低和营养素摄入量低的危险因素之间存在重叠，分别。本研究旨在探讨老年住院患者营养不良评估与低摄入脱水结果之间的一致性。
方法：在老年医院病房住院的年龄≥65岁的患者在入院后96小时内进行资格筛选。用计算的血清渗透压≥295mmol/L(1.86×(Na++K+)+1.15×葡萄糖+尿素+14)评估脱水,用NRS-2002≥3分评估营养不良（风险），MNA-SF≤7分,MNA-LF<17，必须≥2分，用NRS-2002和MNA-LF筛查后的GLIM。关于运动康复的后续数据，再入院,出院后30天收集死亡率。使用的统计数据是卡方检验，渔民精确测试，和Wilcoxon签署等级测试.
结果：共纳入114例患者（57%为女性）。中位年龄85.5（IQR80；89.25）岁。总共49例(43%)脱水。脱水的女性较少（F：42.9％vs.M:67.7%,p=0.013)。渗透压≥295mmol/L的患者的中位体重较高（68.3（IQR58.5;78.4）与62（IQR51.8；72.1），p=0.021)和中上臂周长(27(IQR26;30)与25.5（IQR22.9；28.3），p=0.004)。在有或没有脱水的人之间，营养不良的患病率没有发现显着差异（NRS-2002；70％vs.81%,p=0.174；MNA-SF：23.1vs.23.2%,p=1.0；MNA-LF：37.1vs.30.2%,p=0.644；必须：24.5vs.33.8%,p=0.308；用NRS-2002筛查后的GLIM：84.4vs.74.5%,p=0.405，用MNA-LF筛选后的GLIM：74.1vs.75.6%,p=0.438)。Kappa值在0附近变化并且反映低一致性。随访数据没有差异，在正常水合和脱水的人之间。
结论：我们发现，在老年住院患者人群中，营养不良和低摄入脱水的评估结果不一致。因此，所有老年患者都应在这两种情况下进行评估。
方法：在老年医院病房住院的年龄≥65岁的患者在入院后96小时内进行资格筛选。用计算的血清渗透压≥295mmol/L(1.86×(Na++K+)+1.15×葡萄糖+尿素+14)评估脱水,用NRS-2002≥3分评估营养不良（风险），MNA-SF≤7分,MNA-LF<17，必须≥2分，用NRS-2002和MNA-LF筛查后的GLIM。关于运动康复的后续数据，再入院,出院后30天收集死亡率。使用的统计数据是卡方检验，渔民精确测试，和Wilcoxon签署等级测试.
结果：共纳入114例患者（57%为女性）。中位年龄85.5（IQR80；89.25）岁。总共49例(43%)脱水。脱水的女性较少（F：42.9％vs.M:67.7%,p=0.013)。渗透压≥295mmol/L的患者的中位体重较高（68.3（IQR58.5;78.4）与62（IQR51.8；72.1），p=0.021)和中上臂周长(27(IQR26;30)与25.5（IQR22.9；28.3），p=0.004)。在有或没有脱水的人之间，营养不良的患病率没有发现显着差异（NRS-2002；70％vs.81%,p=0.174；MNA-SF：23.1vs.23.2%,p=1.0；MNA-LF：37.1vs.30.2%,p=0.644；必须：24.5vs.33.8%,p=0.308；用NRS-2002筛查后的GLIM：84.4vs.74.5%,p=0.405，用MNA-LF筛选后的GLIM：74.1vs.75.6%,p=0.438)。Kappa值在0附近变化并且反映低一致性。随访数据没有差异，在正常水合和脱水的人之间。
结论：我们发现，在老年住院患者人群中，营养不良和低摄入脱水的评估结果不一致。因此，所有老年患者都应在这两种情况下进行评估。
