MALNUTRITION POINT-PREVALENCE FROM 2012 TO 2019 AND ASSOCIATED HEALTH-OUTCOMES IN ADULT PATIENTS IN RURAL HOSPITALS

JAR life Pub Date : 2019-12-01 DOI:10.14283/jarcp.2019.16
Eloisa Lopez, M. Banbury, E. Isenring, Skye Marshall
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Abstract

Background: Malnutrition negatively impacts hospitalised patients and the healthcare system. Objectives: 1) report point-prevalence of hospital malnutrition from 2012 to 2019; and 2) determine if there was an association between nutrition status and health-related outcomes. Design: Point-prevalence of malnutrition was determined by three (2012, 2014, and 2019) cross-sectional studies. Health-related outcomes, assessed by a prospective cohort study in 2014, were length of stay, in-hospital mortality, hospital readmission, infection, falls, fractures, and pressure wounds. Setting: three Australian rural hospitals. Participants: Adult inpatients. Measurements: Nutrition status was assessed with the Subjective Global Assessment (SGA) tool. Results: Malnutrition point prevalence was 39% in 2012 (n=62), 48% in 2014 (n=128), and 28% in 2019 (n=96); where the prevalence in 2019 was significantly lower than in 2014 (p<0.017). The 2019 (median age 70 years) sample was younger than the 2012 (median age 80 years) and 2014 (median age 78 years) samples (p<0.05). Mortality and falls rate were higher in the severely malnourished participants (p=<0.05); and severe malnutrition may predict mortality (Adjusted OR: 3.47 (95%CI: 0.94, 12.78] p=0.061). Conclusions: Nutrition status did not predict other health-related outcomes. The rate of malnutrition in rural hospitals was consistently high and may increase the risk of in-hospital mortality.
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2012 - 2019年农村医院成年患者营养不良点患病率及相关健康结局
背景:营养不良对住院患者和医疗保健系统产生负面影响。目的:1)报告2012 - 2019年医院营养不良的点患病率;2)确定营养状况与健康相关结果之间是否存在关联。设计:通过三项横断面研究(2012年、2014年和2019年)确定营养不良的点流行率。2014年的一项前瞻性队列研究评估了与健康相关的结果,包括住院时间、住院死亡率、再入院率、感染、跌倒、骨折和压伤。环境:三家澳大利亚农村医院。参与者:成年住院患者。测量方法:采用主观整体评估(SGA)工具评估营养状况。结果:2012年营养不良点患病率为39% (n=62), 2014年为48% (n=128), 2019年为28% (n=96);其中2019年的患病率明显低于2014年(p<0.017)。2019年(中位年龄70岁)的样本比2012年(中位年龄80岁)和2014年(中位年龄78岁)的样本年轻(p<0.05)。严重营养不良组的死亡率和跌倒率较高(p=<0.05);和严重营养不良可能预测死亡率(校正OR: 3.47 (95%CI: 0.94, 12.78) p=0.061)。结论:营养状况不能预测其他与健康相关的结果。农村医院的营养不良率一直很高,可能会增加院内死亡的风险。
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