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.
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。