PDF(Pubmed)
Abstract：
BACKGROUND: Malnutrition is a prevalent and hard-to-treat condition in older adults. enteral feeding is common in acute and long-term care. Data regarding the prognosis of patients receiving enteral feeding in geriatric medical settings is lacking. Such data is important for decision-making and preliminary instructions for patients, caregivers, and physicians. This study aimed to evaluate the prognosis and risk factors for mortality among older adults admitted to a geriatric medical center receiving or starting enteral nutrition (EN).
METHODS: A cohort retrospective study, conducted from 2019 to 2021. Patients admitted to our geriatric medical center who received EN were included. Data was collected from electronic medical records including demographic, clinical, and blood tests, duration of enteral feeding, Norton scale, and Short Nutritional Assessment Questionnaire score. Mortality was assessed during and after hospitalization. Data were compared between survivors and non-survivors. Multivariate logistic regressions were performed to identify the variables most significantly associated with in-hospital mortality.
RESULTS: Of 9169 patients admitted, 124 (1.35%) received enteral feeding tubes. More than half of the patients (50.8%) had polypharmacy (over 8 medications), 62% suffered from more than 10 chronic illnesses and the majority of patients (122/124) had a Norton scale under 14. Most of the patients had a nasogastric tube (NGT) (95/124) and 29 had percutaneous endoscopic gastrostomies (PEGs). Ninety patients (72%) died during the trial period with a median follow-up of 12.7 months (0.1-62.9 months) and one-year mortality was 16% (20/124). Associations to mortality were found for marital status, oxygen use, and Red Cell Distribution Width (RDW). Age and poly-morbidity were not associated with mortality.
CONCLUSIONS: In patients receiving EN at a geriatric medical center mortality was lower than in a general hospital. The prognosis remained grim with high mortality rates and low quality of life. This data should aid decision-making and promote preliminary instructions.
METHODS: A cohort retrospective study, conducted from 2019 to 2021. Patients admitted to our geriatric medical center who received EN were included. Data was collected from electronic medical records including demographic, clinical, and blood tests, duration of enteral feeding, Norton scale, and Short Nutritional Assessment Questionnaire score. Mortality was assessed during and after hospitalization. Data were compared between survivors and non-survivors. Multivariate logistic regressions were performed to identify the variables most significantly associated with in-hospital mortality.
RESULTS: Of 9169 patients admitted, 124 (1.35%) received enteral feeding tubes. More than half of the patients (50.8%) had polypharmacy (over 8 medications), 62% suffered from more than 10 chronic illnesses and the majority of patients (122/124) had a Norton scale under 14. Most of the patients had a nasogastric tube (NGT) (95/124) and 29 had percutaneous endoscopic gastrostomies (PEGs). Ninety patients (72%) died during the trial period with a median follow-up of 12.7 months (0.1-62.9 months) and one-year mortality was 16% (20/124). Associations to mortality were found for marital status, oxygen use, and Red Cell Distribution Width (RDW). Age and poly-morbidity were not associated with mortality.
CONCLUSIONS: In patients receiving EN at a geriatric medical center mortality was lower than in a general hospital. The prognosis remained grim with high mortality rates and low quality of life. This data should aid decision-making and promote preliminary instructions.
摘要：
背景：营养不良是老年人普遍存在且难以治疗的疾病。肠内喂养在急性和长期护理中很常见。缺乏有关在老年医疗环境中接受肠内喂养的患者预后的数据。这些数据对于患者的决策和初步指导非常重要，看护者,和医生。这项研究旨在评估接受或开始肠内营养（EN）的老年医疗中心收治的老年人的预后和死亡风险因素。
方法：一项队列回顾性研究，从2019年到2021年进行。纳入我们老年医疗中心接受EN的患者。数据来自电子医疗记录，包括人口统计，临床,还有血液测试,肠内喂养的持续时间，诺顿秤,和简短的营养评估问卷评分。在住院期间和住院后评估死亡率。在幸存者和非幸存者之间比较数据。进行多变量逻辑回归以确定与住院死亡率最显著相关的变量。
结果：在9169名患者中，124例（1.35%）接受肠内饲管。超过一半的患者（50.8％）使用多种药物（超过8种药物），62%的人患有10多种慢性疾病，大多数患者(122/124)的诺顿量表在14岁以下。大多数患者接受了鼻胃管（NGT）（95/124），29例接受了经皮内镜胃造瘘术（PEG）。90名患者（72％）在试验期间死亡，中位随访时间为12.7个月（0.1-62.9个月），一年死亡率为16％（20/124）。婚姻状况与死亡率有关联，氧气使用,和红细胞分布宽度（RDW）。年龄和多发病率与死亡率无关。
结论：老年医疗中心接受EN的患者死亡率低于综合医院。预后仍然严峻，死亡率高，生活质量低。这些数据应有助于决策并促进初步指导。
方法：一项队列回顾性研究，从2019年到2021年进行。纳入我们老年医疗中心接受EN的患者。数据来自电子医疗记录，包括人口统计，临床,还有血液测试,肠内喂养的持续时间，诺顿秤,和简短的营养评估问卷评分。在住院期间和住院后评估死亡率。在幸存者和非幸存者之间比较数据。进行多变量逻辑回归以确定与住院死亡率最显著相关的变量。
结果：在9169名患者中，124例（1.35%）接受肠内饲管。超过一半的患者（50.8％）使用多种药物（超过8种药物），62%的人患有10多种慢性疾病，大多数患者(122/124)的诺顿量表在14岁以下。大多数患者接受了鼻胃管（NGT）（95/124），29例接受了经皮内镜胃造瘘术（PEG）。90名患者（72％）在试验期间死亡，中位随访时间为12.7个月（0.1-62.9个月），一年死亡率为16％（20/124）。婚姻状况与死亡率有关联，氧气使用,和红细胞分布宽度（RDW）。年龄和多发病率与死亡率无关。
结论：老年医疗中心接受EN的患者死亡率低于综合医院。预后仍然严峻，死亡率高，生活质量低。这些数据应有助于决策并促进初步指导。
