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[老年住院患者营养风险评估——应考虑哪些体重指数和体重减轻程度?]

[Assessment of nutritional risks among elderly hospitalized patients - which body mass index and degree of weight loss should be considered?].

作者信息

Beck A M, Ovesen L F

机构信息

Afdelingen for ernaering, Institut for Fødevareundersøgelser, Søborg.

出版信息

Ugeskr Laeger. 1999 Nov 22;161(47):6477-9.

Abstract

The "Subjective Global Assessment", the "Nutrition Risk Score" and a Danish counterpart are simple screening methods to detect patients at risk of nutrition-related complications. The cut-off points used in the screening are a body mass index (BMI) less than 20 kg/m2 (or 18.5 kg/m2 in the Danish version) and weight loss of more than 5% during the last month--regardless of age. This review of the literature indicates that the optimal range of BMI for elderly people is increasing from 18.7-25 kg/m2 to 24-29 kg/m2. It also suggests that a clinically significant weight loss for the elderly is around 5% annually, less than in younger age groups. Finally, there seems to be a high percentage of the old, especially those initially malnourished, who will not benefit from nutritional support. In conclusion, other cut-off points should be used for elderly (65+ years) patients, i.e. BMI less than 24 kg/m2 or any degree of weight loss.

摘要

“主观全面评定法”、“营养风险评分”以及丹麦的类似方法都是用于检测有营养相关并发症风险患者的简单筛查方法。筛查所采用的临界值为体重指数(BMI)低于20kg/m²(丹麦版本中为18.5kg/m²)以及过去一个月内体重减轻超过5%——无论年龄大小。对文献的此项综述表明,老年人BMI的最佳范围正从18.7 - 25kg/m²增至24 - 29kg/m²。这还表明,老年人临床上显著的体重减轻约为每年5%,低于年轻人群体。最后,似乎有很大比例的老年人,尤其是那些最初就营养不良的老年人,无法从营养支持中获益。总之,对于65岁及以上的老年患者应采用其他临界值,即BMI低于24kg/m²或任何程度的体重减轻。

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