目的:营养不良对临床结局有不利影响,体弱的老年人可能面临更大的营养不良风险。这项研究的目的和目的是调查一组虚弱的老年医院患者中营养不良风险标志物与临床结局之间的关系。
方法:78名虚弱的老年住院患者记录了以下测量结果:住院时间(LOS),出院医疗健身时间(TMFFD),体重指数(BMI),营养不良通用筛查工具(MUST)和小型营养评估简表(MNA-SF)评分,血尿素,C反应蛋白(CRP),白蛋白,CRP-白蛋白比值;和生物电阻抗评估(BIA)测量(n=66)。患者按入院后12个月的死亡率进行分组。按白蛋白分类进行分组(n=66),<30g/l表示严重营养不良,30-34.9,中度和>35,低。对作为死亡率潜在预测因子的变量进行受试者工作特征(ROC)曲线分析。
结果:12个月后,31%(n=24)的患者死亡。本组LOS明显增高(25.0±22.9vs15.4±12.7d,P<0.05)。BMI(23.8±4.9vs26.4±5.5kg/m2);脂肪量(FM)(17.2±9.9vs25.5±10.5kg),脂肪质量指数(FMI)(9.3±4.1vs17.9±2.4kg/m2);MNA-SF评分(6.6±2.4vs8.6±2.7)明显降低(P<0.05),尿素明显更高(11.4±8.7vs8.8±4.4mmol/l,P=0.05)。白蛋白在整个组中通常较低(30.5±5.9g/l),并且在白蛋白和MNA-SF评分之间鉴定出潜在的关系。MNA-SF,FM,通过ROC曲线分析,FMI和FMI是死亡率结果的重要预测因子,而必须是一个较差的预测指标。
结论:这项研究强调了虚弱的老年医院患者营养不良风险指标与临床结果之间的潜在关系,应在更大的队列中进行研究,以改善患者护理。
OBJECTIVE: Malnutrition has an adverse effect on clinical outcomes and frail older people may be at greater risk of malnutrition. The purpose and aims of this study was to investigate the relationship between markers of malnutrition risk and clinical outcomes in a cohort of frail older hospital patients.
METHODS: 78 frail older hospital patients had the following measurements recorded; length of stay (LOS), time to medical fitness for discharge (TMFFD), body mass index (BMI), malnutrition universal screening tool (MUST) and mini-nutritional assessment short-form (MNA-SF) scores, blood urea, C-reactive protein (CRP), albumin, CRP-albumin ratio; and bioelectrical impedance assessment (BIA) measurements (n = 66). Patients were grouped by mortality status 12 months post hospital admission. Grouping by albumin classification was performed (n = 66) whereby, <30 g/l indicated severe malnutrition, 30-34.9, moderate and >35, low. Receiver-operating characteristic (ROC) curve analysis was performed on variables as potential predictors of mortality.
RESULTS: After 12 months, 31% (n = 24) of patients died. LOS was significantly greater in this group (25.0 ± 22.9 vs 15.4 ± 12.7d, P < 0.05). BMI (23.8 ± 4.9 vs 26.4 ± 5.5 kg/m2); fat mass (FM) (17.2 ± 9.9 vs 25.5 ± 10.5 kg), fat mass index (FMI) (9.3 ± 4.1 vs 17.9 ± 2.4 kg/m2); and MNA-SF score (6.6 ± 2.4 vs 8.6 ± 2.7) were significantly lower (P < 0.05), and urea significantly higher (11.4 ± 8.7 vs 8.8 ± 4.4 mmol/l, P = 0.05). Albumin was typically low across the entire group (30.5 ± 5.9 g/l) and a potential relationship was identified between albumin and MNA-SF score. MNA-SF, FM, and FMI were significant predictors of mortality outcome by ROC curve analysis, whereas MUST was a poor predictor.
CONCLUSIONS: This study highlights a potential relationship between indicators of malnutrition risk and clinical outcomes in frail older hospital patients which should be studied in larger cohorts with an aim to improve patient care.