住院患者营养状况及预后评估

JAR life Pub Date : 2019-01-01 DOI:10.14283/jarcp.2019.3
J. Ares Blanco, L. Moreno Díaz, E. Fernández-Fernández, A. López-Alba
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引用次数: 0

摘要

背景:营养不良与死亡率之间存在关联。然而,尚不清楚这种关联是否真正独立于混杂因素。目的:本研究的目的是根据营养筛查工具“迷你营养评估”中定义的三类来评估营养状况,并探讨其与预后的关系。设计、环境和参与者:2013年12月至2014年1月住院患者的单队列回顾性观察研究,这些患者被观察到2015年9月(21个月)(n=144)。在研究开始时,通过MNA简表以及临床和流行病学数据确定营养状况。结果:根据MNA SF定义的分类,营养良好59例(40.97%),营养不良风险55例(38.19%),营养不良30例(20.83%)。随访期间死亡45例(31.25%)。其中,40%(18人)营养不良,38%(17人)有营养不良风险,22%(9人)营养良好。在调整混杂因素后,与参照组(营养良好的患者)相比,营养不良组全因死亡率的危险比(95% CI)显著更高(3.44 (1,27-9,31:p 0,015))。结论:根据MNA简写中定义的3个类别定义的营养状况,在调整了年龄和合并症等混杂因素后,可以预测住院患者中期死亡的概率。这些数据表明了解住院期间的营养状况对于避免潜在并发症和帮助患者克服它们的重要性。
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EVALUATION OF INPATIENTS NUTRITIONAL STATUS AND PROGNOSTIC INVOLVEMENT
Background: There is an association between malnutrition and mortality. However, it is unclear if this association is truly independent of confounding factors. Objectives: The objective of this study is to evaluate nutritional status, defined according to the three categories defined in the Nutritional Screening Tool “Mini Nutritional Assessment”, and to investigate its prognostic involvement. Design, Setting and Participants: Single cohort retrospective observational study in hospitalized patients between December 2013 and January 2014, who were placed under observation until September 2015 (21 months) (n=144). Nutritional status was determined by MNA short form at the beginning of the study, as well as clinical and epidemiological data. Results: Based on categories defined by MNA SF, 59 (40.97%) were well nourished, 55 (38.19%) were at risk of malnutrition, and 30 (20.83%) patients showed malnutrition. 45 patients died during follow up (31.25%). Of them, 40% (18) were malnourished, 38% (17), at risk of malnutrition, and 22% (9), well nourished. After adjusting for confounding factors, hazard ratio (95% CI) for all-cause mortality was significantly greater in the malnourished group (3.44 (1,27-9,31: p 0,015)), comparing to the reference group (well-nourished patients). Conclusions: Nutritional status defined according to the 3 categories defined in MNA short form predicts the probability of mid-term death in hospitalized patients, after adjusting for confounding factors as age and comorbidities. These data show the importance of knowing nutritional status during hospitalization for avoiding potential complications and helping the patient to overcome them.
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