心血管内科老年住院患者营养风险筛查分析及与住院时间的关系研究  

Nutrion Risk Screening in Cardiovascular Medical Senile Inpatients and Its Relation to the Length of Stay

作　　者：黄蕾[1] 张继红[2] 李公任[2] 宋宝梅[2] 宣兵[2] 

机构地区：[1]成都军区总医院营养科,四川省成都市610083 [2]成都军区总医院心血管内科,四川省成都市610083

出　　处：《中国全科医学》2011年第11期1185-1188,共4页Chinese General Practice

摘　　要：目的探讨营养风险筛查在心血管内科老年患者中的使用及其与住院时间的关系,以便选择较准确的筛查方法进行营养风险评估,及时实施营养干预,改善临床结局。方法测定200例老年患者入院时各项营养指标和住院时间(LOS),采用营养风险筛查(NRS2002)和营养风险指数(NR I)两种筛查工具进行营养风险筛查分析。分析营养风险状态与LOS的关系、LOS与营养风险评分及营养指标的相关性,比较不同LOS患者的营养风险评分及营养指标。结果 NRS2002对营养风险的检出率明显高于NR I,两组筛查工具不具有一致性(κ=0.115,P=0.0005);NRS2002筛查显示存在轻微营养风险、中度营养风险及重度营养风险的患者中LOS延长(≥11 d)的比例较无营养风险组患者明显升高(χ2=6.290,P=0.012;χ2=11.674,P=0.001;χ2=4.800,P=0.028);3组患者发生LOS延长的比值比(OR)分别是无营养风险组的4.08、7.09和6.00倍。LOS与NRS2002评分呈正相关关系(r=0.264,P=0.0005),与体质指数(BM I)呈负相关关系(r=-0.155,P=0.033);LOS≥11 d的患者较LOS为1～10 d的患者NRS2002评分明显升高,差异有统计学意义(t=-2.654,P=0.009);LOS≥11 d的患者BM I明显低于LOS为1～10d的患者,差异有统计学意义(t=2.018,P=0.045)。结论 NRS2002与LOS具有较好的相关性和较高营养风险检出率,可用于心血管内科老年患者的营养风险筛查。Objective To investigate the application of nutrition risk screening in cardiovascular medical senile inpatients and its relation to the clinical outcome so as to choose a more accurate screening method to evaluate the nutrition risk,implement the timely nutritional intervention and improve the clinical outcome.Methods The nutrition indexes were determined at the time of the 200 senile patients′ admission.Count the length of stay at the time of the patients discharging from hospital.Nutrition Risk Screening2002（NRS2002） and Nutrition Risk Index（NRI） were adopted to analyze and compare.The relation between the state of the nutrition risk and the length of stay（LOS,d） was analyzed.The correlation between the LOS and the score of nutrition risk,the correlation between the LOS and the nutritive index were analyzed.The scores of nutrition risks and the nutritive indexes were compared with in the various LOS.Results The detectable rate of the nutrition risk by the NRS2002 was higher than NRI（κ=0.115）.The proportion of the prolongation of LOS（≥11 days） was higher in the patients who were at low,medium and high nutrition risk in the screening with NRS2002 than in those who were free from nutrition risk（P=0.012,P=0.001,P=0.028）.The odd ratio of the prolongation of LOS in the 3 groups was 4.08、7.09 and 6 times repectively that in the group free from nutrition risk.The LOS showed a correlation with the score of the NRS2002 and BMI（P=0.0005,P=0.033）.The score of the NRS2002 and BMI were higher and lower respectively in the group of patients whose LOS was more than or equal to 11d than in the group of patients whose LOS was 1～10 days,which showed a significant difference（P=0.009,P=0.045）.Conclusion There is a better correlation between the NRS2002 and the LOS,with a higher nutrition risk detectable rate,which can be used in the screening of the nutrition risk in cardiovascular medical senile patients.

关 键 词：老年 心血管疾病 营养评价 住院时间 

分 类 号：R153.3[医药卫生—营养与食品卫生学]