背景:吞咽困难,作为一种老年综合征,在重症监护病房(ICU)普遍存在。由吞咽障碍引起的营养不良可能与ICU不良结局相关。包括谵妄,从而增加护理和住院费用。然而,营养不良在ICU临床护理实践中没有得到应有的重视。作为两种可预防和纠正的疾病-营养不良和谵妄-早期识别和干预的优势是巨大的。探讨营养不良与谵妄的关系,从ICU吞咽困难的老年患者的高危人群出发,将帮助我们及时有效地管理患者。
目的:探讨ICU老年吞咽困难患者营养不良与谵妄发生率的关系。
■这是一项回顾性研究。本研究的数据来自重症监护医学信息集市-IV。纳入的所有2273例患者均为吞咽困难患者,年龄超过65岁,入住ICU,用logistic回归分析营养不良与谵妄的关系。我们还使用倾向得分匹配(PSM)进行敏感性分析。
结果:在纳入的吞咽困难患者中,13%的人(297/2273)表现出营养不良,谵妄发生率为55.9%(166/297)。在非营养不良组中(1976/2273),谵妄发生率为35.6%(704/1976)。在调整31个协变量后,多因素logistic回归分析显示,营养不良与ICU老年吞咽困难患者谵妄发生率呈显著正相关(校正比值比(OR)=1.96,95%置信区间(CI)=1.47~2.62).通过PSM分析后,结果保持稳定。
结论:营养不良与ICU老年吞咽困难患者谵妄发生率呈显著正相关。ICU应充分重视营养不良。
结论:ICU护士应特别注意营养不良,尤其是吞咽困难患者的高患病率组。对这些患者进行早期识别和营养干预可能有助于降低护理成本和医疗保健支出。
BACKGROUND: Dysphagia, as a geriatric syndrome, is prevalent in the intensive care unit (ICU). Malnutrition resulting from swallowing disorders is likely to correlate with adverse ICU outcomes, including delirium, thereby escalating the costs of care and hospitalization. However, malnutrition has not received the attention it deserves in ICU clinical nursing practice. As two preventable and correctable conditions-malnutrition and delirium-the advantages of early identification and intervention are substantial. Exploring the relationship between malnutrition and delirium, starting from the high-risk group of elderly patients with swallowing difficulties in the ICU, will aid us in managing patients promptly and effectively.
OBJECTIVE: To investigate the relationship between malnutrition and the incidence of delirium in elderly patients with
dysphagia in the ICU.
UNASSIGNED: This is a retrospective study. Data for this study were obtained from the Medical Information Mart for Intensive Care-IV. All 2273 patients included were
dysphagia older patients over 65 years of age admitted to the ICU, and logistic regression was used to explore the relationship between malnutrition and delirium. We also used propensity score matching (PSM) for sensitivity analysis.
RESULTS: Among the included patients with swallowing difficulties, 13% individuals (297/2273) exhibited malnutrition, with a delirium incidence rate of 55.9% (166/297). In the non-malnutrition group (1976/2273), the delirium incidence rate is 35.6% (704/1976). After adjusting for 31 covariates, multifactorial logistic regression showed that malnutrition was significantly positively associated with the incidence of delirium in elderly dysphagic patients in the ICU (adjusted odds ratio (OR) = 1.96, 95% confidence interval (CI) = 1.47-2.62). The results remained stable after analysis by PSM.
CONCLUSIONS: Malnutrition was significantly positively associated with the incidence of delirium in elderly dysphagic patients in the ICU. Malnutrition should be given adequate attention in the ICU.
CONCLUSIONS: ICU nurses should pay particular attention to malnutrition, especially among the high-prevalence group of patients with
dysphagia. Early identification and nutritional intervention for these patients may help reduce the costs of care and health care expenditures.