老年慢性心力衰竭患者营养状态与非计划再入院的相关性分析  

Correlation between nutritional status and unplanned readmission in elderly patients with chronic heart failure

作　　者：刘静[1] 刘健[1] 梁倩[1] 延泽萍 栾晓嵘[2] 王芬[3] Liu Jing;Liu Jian;Liang Qian;Yan Zeping;Luan Xiaorong;Wang Fen(College of Nursing and Rehabilitation,Shandong University,Jinan 250014,China;Department of Hospital Infection,Qilu Hospital of Shandong University,Jinan 250014,China;Department of Cardiology,Qilu Hospital of Shandong University,Jinan 250014,China)

机构地区：[1]山东大学护理与康复学院,济南250014 [2]山东大学齐鲁医院医院感染管理处,济南250014 [3]山东大学齐鲁医院心内科,济南250014

出　　处：《中国实用护理杂志》2022年第21期1619-1625,共7页Chinese Journal of Practical Nursing

基　　金：山东省自然科学基金面上项目(ZR2020MG071)。

摘　　要：目的评估老年慢性心力衰竭患者的营养状态,并探讨其与非计划再入院的相关性。方法采用前瞻性队列研究,选择2020年7月至2021年8月山东大学齐鲁医院因慢性心力衰竭住院的220例老年患者。收集患者基本信息、实验室检查等资料,采用老年营养风险指数评估患者营养状态并进行分组。采用R4.1.1和SPSS26.0对资料进行分析,使用Kaplan-Meier法绘制生存曲线,应用单因素及多因素Cox回归分析老年慢性心力衰竭患者的营养状态与非计划再入院的关系。结果220例老年慢性心力衰竭患者中,营养正常占59.5%(131/220);营养不良占40.5%(89/220),其中,轻度营养不良占26.8%(59/220),中重度营养不良占13.6%(30/220)。随访患者中有25.9%(57/220)的患者发生非计划再入院。Kaplan-Meier生存曲线显示,中重度营养不良患者较营养正常、轻度营养不良患者非计划再入院的发生率高,三者之间差异有统计学意义(P<0.05)。多因素Cox回归分析显示,中重度营养不良为老年慢性心力衰竭患者非计划再入院的独立预测因素(HR=2.064,95%CI 1.029~4.138,P<0.05)。结论老年慢性心力衰竭患者营养不良发生率高,中重度营养不良是老年慢性心力衰竭患者非计划再入院的独立预测因素。老年营养风险指数是有效的营养筛查工具,可为临床评估老年慢性心力衰竭患者营养风险提供参考。Objective To evaluate nutritional status in elderly patients with chronic heart failure and to investigate its association with unplanned readmission.Methods From July 2020 to August 2021,220 elderly patients hospitalized for chronic heart failure in Qilu Hospital of Shandong University were enrolled in a prospective cohort study.Basic information,laboratory tests and other data of the patients were collected.Nutritional status of the patients was assessed by geriatric nutritional risk index and the patients were divided into groups.Data were analyzed by R4.1.1 and SPSS26.0,survival curves were drawn by Kaplan-Meier method,and the relationship between nutritional status and unplanned readmission in elderly patients with chronic heart failure was analyzed by univariate and multivariate Cox regression.Results Among 220 elderly patients with chronic heart failure,59.5%(131/220)were in normal nutrition.There were 40.5%(89/220)in the malnutrition,including 26.8%(59/220)in the mild malnutrition and 13.6%(30/220)in the moderate and severe malnutrition.During the follow-up period of 3 months,25.9%(57/220)had unplanned readmission.Kaplan-Meier survival curve showed that the incidence of unplanned readmissions was higher in the moderate and severe malnutrition than in the normal and mild malnutrition,and the difference among them was statistically significant(P<0.05).Multivariate Cox regression analysis showed that moderate and severe malnutrition was an independent predictor of unplanned readmission in elderly patients with chronic heart failure(HR=2.064,95%CI 1.029-4.138,P<0.05).Conclusions The prevalence of malnutrition in elderly patients with chronic heart failure is high.Moderate and severe malnutrition is an independent predictor of unplanned readmission in elderly patients with chronic heart failure.The geriatric nutritional risk index is an effective screening tool and can provide a reference for clinical evaluation of nutritional risk in patients.

关 键 词：心力衰竭 慢性 老年人 营养不良 预后 再入院 

分 类 号：R473.5[医药卫生—护理学]