80岁以上住院患者营养风险筛查与评估  

Nutritional risk screening and assessment in elderly patients aged over 80 years

作　　者：刘海燕[1] 李虹[1] 唐海英[1] 李建中[1] LIU Hai-yan LI Hong TANG Hai- ying LI Jian-zhong.(Department of Geriatrics, the First Affiliated Hospital of Soochow University, Suzhou 215006, China)

机构地区：[1]苏州大学附属第一医院老年医学科,江苏省苏州市215006

出　　处：《实用老年医学》2016年第12期1014-1016,1019,共4页Practical Geriatrics

摘　　要：目的运用多种评估方法对>80岁的高龄住院患者进行营养状况评估并进行比较,同时分析不同疾病状态的高龄患者存在营养风险或营养不良的情况。方法收集>80岁的高龄住院患者200例,采用营养风险筛查2002(NRS2002)、微型营养评价法(MNA-SF)以及传统营养状况评价指标包括体质量指数(BMI)、血清白蛋白(Alb)、血红蛋白(Hb)对其营养状况进行评估,Kappa检验分析不同评估方法间的一致性,并对不同疾病状态高龄患者的营养状况进行比较。结果 NRS2002筛查显示高龄住院老人中具有营养风险者占52.50%。MNA-SF评估结果显示高龄患者中营养不良者占36.50%,具有营养不良风险者占41.00%,而营养良好者占22.50%。以BMI或Alb作为评判营养状态指标,营养不良者占10.50%。以Hb为评估标准,高龄患者中发生营养不良的比例为44.50%。MNA-SF和NRS2002评估方法具有中度一致性(Kappa=0.445),而BMI/Alb或Hb与NRS2002的一致性较差(Kappa=0.173或0.264)。具有认知功能障碍的高龄患者中营养不良风险和营养不良的发生率均显著高于没有认知功能障碍者(P<0.05)。结论高龄住院老人的营养风险和营养不良发生率高,其中具有认知功能障碍的高龄老人营养状况更差。Objective To investigate the nutrition status of elderly patients aged more than 80 years by different assessment tools,and to compare the prevalence of malnutrition or nutritional risk among patients with different diseases.Methods 200 elderly patients aged over 80 years were enrolled in this study. Nutrition risk screening 2002（ NRS2002）,short-form mini-nutritional assessment（ MNA-SF） and nutritional parameters such as body mass index（ BMI）,albumin（ Alb）,hemoglobin（ Hb） were used to analyze the nutrition status of patients with different diseases. Consistency among the screening tools were measured by Kappa coefficient. Results Detected by NRS2002,52. 50% of the participants were at risk of malnutrition. According to MNA-SF,the prevalence of malnutrition was 36. 50%,and 41. 00% of patients were at risk of malnutrition and 22. 50% of patients showed well nutrition. With the evaluation by BMI or Alb,the incidence of malnutrition was 10. 50%. 44. 50% of patients showed malnutrition if assessed by Hb only. Kappa testing showed that NRS2002 and MNASF were in moderate consistency（ Kappa = 0. 445）. The nutrition status assessed by BMI / Alb or Hb were poorly consistent to NRS2002（ Kappa = 0. 173 or 0. 264）. Patients with cognitive dysfunction had higher risk of malnutrition and higher incidence rate of malnutrition than those without cognitive dysfunction. Conclusions The prevalence of malnutrition risk or malnutrition is high in patients aged more than 80 years,especially in those with cognitive dysfunction.

关 键 词：高龄 营养不良 营养风险筛查2002 微型营养评价法 

分 类 号：R589.2[医药卫生—内分泌]