[Malnutrition in geriatric patients: risk factor residential nursing home?]

HeilberufeSCIENCE Pub Date : 2021-01-01 Epub Date: 2021-06-11 DOI:10.1007/s16024-021-00353-z
Fabian Graeb, Reinhold Wolke
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Abstract

Background: Malnutrition remains a challenging problem in hospitals, especially among geriatric patients. The background and causes are actually well known but still underestimated in clinical practice.

Aim and methods: This study evaluated possible differences in rates of malnutrition risk and malnutrition in geriatric patients living at home and geriatric patients living in residential nursing homes. For this purpose, data from a total of 4 surveys (3 times nutritionDay plus 1 additional survey) were combined and evaluated. In this secondary analysis, 258 patients 65 years and older are included. Malnutrition risk is determined by the malnutrition universal screening tool (MUST) and malnutrition by the ESPEN criteria.

Results: Of the patients 86.0% (n = 222) live at home and 14.0% (n = 36) in residential nursing homes. The patients living in nursing homes have a higher morbidity and need of care. Indicators for the increased morbidity are a larger number of nights spent in the clinic in the last 12 months (mdn 10.0 vs. 5; p 0.007), higher number of daily drug intake (mdn 9.0 vs. 7.0; p 0.002) and greater limitations in walking abilities (mdn 3.0 vs. 1.0; p < 0.001). They are significant older (median 86.0 vs. 78.0; p < 0.001) and show a higher percentage of manifest malnutrition (35.7%; n = 10 vs. 20.1%; n = 40; p 0.062).

Conclusion: Geriatric patients living at home and in residential nursing homes show high rates of malnutrition. A malnutrition screening at the beginning and during hospital stay is urgently required in every case as this is the only way to identify those affected. In addition, regular screening in outpatient departments as well as in nursing homes is also necessary.

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老年患者营养不良:寄宿养老院的危险因素?]
背景:营养不良仍然是医院中一个具有挑战性的问题,特别是在老年患者中。其背景和原因其实是众所周知的,但在临床实践中仍被低估。目的和方法:本研究评估了生活在家里的老年患者和生活在养老院的老年患者营养不良风险和营养不良发生率的可能差异。为此,我们对共4项调查(3次 次nutritionDay加上1次额外调查)的数据进行了合并和评估。在这个二次分析中,258名65岁及以上的患者被纳入。营养不良风险由营养不良普遍筛查工具(MUST)和ESPEN标准确定。结果:86.0% (n = 222)的患者住在家中,14.0% (n = 36)的患者住在养老院。住在养老院的病人发病率高,需要照顾。发病率增加的指标是过去12个月内在诊所度过的夜晚数量增加(mdn 10.0 vs. 5;P 0.007),每日服药次数较高(mdn 9.0 vs. 7.0;P 0.002)和行走能力的更大限制(mdn 3.0 vs. 1.0;P P n = 10 vs. 20.1%;n = 40;p 0.062)。结论:居家和寄宿型老年患者营养不良发生率较高。在任何情况下,都迫切需要在开始和住院期间进行营养不良筛查,因为这是确定受影响者的唯一途径。此外,门诊和养老院的定期筛查也是必要的。
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