老年住院患者营养状况对预后影响的临床观察  

Nutritional status affects clinical outcomes in elderly inpatients

作　　者：王丹[1] 郝瑞瑞[1] 姜春燕[1] 

机构地区：[1]首都医科大学附属北京友谊医院医疗保健中心内科,北京100050

出　　处：《临床和实验医学杂志》2016年第16期1571-1574,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市中医管理局青年科学研究资助项目(QN-2011-08);首都医科大学基础临床合作研究基金(12-JL-38)

摘　　要：目的应用微型营养评估简表(MNA-SF)评估老年住院患者的营养状况,分析其对临床预后的影响。方法以2014年8月至2015年8月期间在北京友谊医院医疗保健中心住院的老年患者为研究对象,入院72 h内进行MNA-SF问卷调查,前瞻性观察患者的临床预后(院内感染、住院时间、死亡),分析营养状况与临床预后的关系,同时调查其住院期间的营养支持情况。结果 275例老年住院患者应用MNA-SF评估为正常营养者165例(60.00%),营养不良风险者78例(28.36%),营养不良者32例(11.64%)。营养不良组患者医院获得性感染的发生率高于营养正常组(P<0.05)。营养不良组和营养不良风险组患者住院时间显著高于营养正常组(P<0.01)。275例患者中9例住院期间死亡,其中5例发生在营养不良组,营养不良患者的病死率较营养正常组显著增高(P<0.01)。营养不良组患者接受营养支持的比率为40.6%,肠内和肠外营养的应用比例为4.25︰1。结论老年住院患者中存在营养不良及营养不良风险的比率较高,营养不良是影响老年患者住院期间临床预后的重要因素。Objectiye To assess the nutritional status with MNA - SF and to investigate its relationship to clinical outcomes in elderly in-patients. Methods Elderly inpatients aged over 60 years in health care center,Beijing Friendship Hospital were enrolled in this investigation from August 2014 to August 2015. The nutritional status of all the participants was assessed with the Mini Nutritional Assessment Short - Form（MNA- SF）within 72 h after admission. The clinical outcomes of the participants（including hospital acquired infection,length of stay,and death） were observed prospectively. The relationship between nutritional status and clinical outcomes of these inpatients was analyzed and the nutrition supports they received were investigated. Results All the enrolled elderly inpatients completed the investigation. There were 165 cases（60. 00% ） at Normalized（MNA - N）,78 cases（28. 36% ）at Malnutrition Risk（MNA - MR）,and 32 cases（11. 64% ）at Malnutrition（MNA - M）. The incidence rate of hospital acquired infection in MNA - M group were higher than that in MNA - N group（ P 〈 0. 05）. The lengths of stay in MNA- M group and MNA - MR group were significantly higher than that in MNA - N group（ P 〈 0. 01）. Nine of 275 participants died during hospi-talization,and five among them were in MNA - M group. The rate of mortality in MNA - M group was significantly higher than that in MNA - N group（ P 〈 0. 01）. 40. 6% of MNA - M patients received nutrition supports. The ratio of enteral nutrition and parenteral nutrition was 4. 25 ：1. Conclusion There is a high ratio in elderly inpatients with malnutrition or malnutrition risk. Malnutrition is an important factor that affects clinical outcomes in elderly inpatients.

关 键 词：老年人 住院患者 营养状况 微型营养评估简表 临床预后 

分 类 号：R459.3[医药卫生—治疗学]