目的：探讨老年科住院患者营养状态与临床结局的关系。方法入选98例2011年11月至2012年3月在中国医学科学院北京协和医院老年科住院的≥60岁的患者进行前瞻性调查。入院72h内完成实验室指标、微型营养评估简表（MNA-SF）、膳食回顾、人体测量和体成分分析等营养评定，观察临床结局（死亡、并发症及总住院时间等）。结果98例患者均全部完成了整个调查，年龄（74.06±7.90）岁。MNA-SF结果正常营养状态者40例（40.82%），营养不良危险37例（37.76%），营养不良21例（21.43%）。营养不良者年龄（79.1±9.3）岁，明显高于其余两组（均P＜0.05）。营养不良者前白蛋白[（114.7±62.5）mg/L，n＝19]水平明显低于营养正常组[（204.0±65.2）mg/L， n＝37，P＜0.05]和营养不良危险组[（175.1±58.3）mg/L，n＝34，P＜0.05]。营养不良组感染并发症（28.6%）明显高于营养正常组（12.5%）和营养不良危险组（5.4%）。营养不良组的平均住院时间[（21.9±8.9）d]均高于营养正常组[（14.9±5.9）d]和营养不良危险组[（15.9±7.5）d，均P＜0.05）]。所有患者死亡2例，均发生在营养不良组。结论住院老年患者，营养不良及营养不良危险的发生率较高。营养不良延长住院老年患者的住院时间，增加感染并发症，甚至可能增加死亡风险。%Objective To investigate the relationship between nutrition status in the elderly inpatients admitted in Geriatric Department and their clinical outcomes. Methods A total of 98 inpatients aged over 60 years from the Geriatric Department of Peking Union Medical College Hospital from November 2011 to March 2012 were enrolled in this study. All the patients were assessed with the Mini Nutritional Assessment Short-Form (MNA-SF) within 72h after admission. At the same period, their anthropometric indices, dietary recall, laboratory indices, and human body composition were also obtained. Clinical outcomes including death, complications, and length of stay (LOS) were observed. Results All enrolled participants completed the entire study. They were at an age of (74.06±7.90) years. MNA-SF indicated that 40 cases (40.82%) were rated as Normalized (MNA-N), 37 cases (37.76%) at Malnutrition Risk (MNA-MR), and 21 cases (21.43%) Malnutrition (MNA-M). The patients in MNA-M [(79.1±9.3) years] were significantly elder than those in MNA-N (both P<0.05). Serum content of pre-albumin was significantly lower in MNA-M patients [(114.7±62.5)mg/L, n=19] than MNA-N [(204.0±65.2)mg/L, n=37] and MNA-MR patients [(175.1±58.3)mg/L, n=34, both P<0.05]. The incidences of infectious complications were obviously higher in MNA-M patients (28.6%) than MNA-N (12.5%) and MNA-MR patients (5.4%). Moreover, LOS in MNA-M patients [(21.9±8.9)d] was much longer than that in MNA-N [(14.9±5.9)d] and MNA-MR [(15.9±7.5)d, both P<0.05)]. There were 2 patients died, both in MNA-M. Conclusion The Elderly inpatients from Geriatric Department are more common in n malnutrition or at risk of malnutrition. Malnutrition will obviously prolong their LOS, and increase the incidences of infectious complications, and even mortality risk.
展开▼
