Gazzotti C, Albert A, Pepinster A, Petermans J
Service de Geriatrie, CHR de la Citadelle, Bd. du 12eme de Ligne, 4000 Liege, Belgium.
J Nutr Health Aging. 2000;4(3):176-81.
This study was undertaken to estimate the prevalence of malnutrition in elderly patients hospitalized with an acute illness, as well as to assess the clinical usefulness of standardized nutritional assessment upon admission by means of the MNA scale.
A prospective study.
A large size regional university hospital.
There were 175 patients (113 women and 62 men) with a mean age of 79.7 + 8.5 years admitted for an acute problem. Death occurred in 11 patients (6.3%).
Upon admission, demographic (age, gender, origin) and medical (disease, drugs) data were recorded for each patient; the MNA questionnaire (score: 0-30) was administered and Katz score (7-28) calculated. At hospital discharge, data included Katz score, outcome (death/survival), and destination.
The mean MNA score was 20.5 + 5.1 and the prevalence of severe malnutrition (MNA <17) was 21.7%. Further, 48.6% of elderly were at risk of malnutrition (MNA between 17 and 24). There was no association between MNA and age or gender, but underweight was a sign of low MNA values (P <.001). MNA scores were inversely related to Katz scores at both admission and hospital discharge (P <.001). Patients originating from nursing homes had a poorer nutritional status than those living at home (MNA: 18.4 against 22.3, P <.001). The number of drugs taken per patient (5.2 + 2.8) was found to be correlated with MNA (P =.049). MNA scores were on average significantly higher (P <.001) in survivors (20.9) than in nonsurvivors (14.1).
The study clearly demonstrates the high prevalence of malnutrition and the clinical usefulness of the MNA scale in geriatric medicine. The MNA score upon admission reflects the patient's nutritional condition, degree of autonomy (Katz score), living conditions and current treatment. It is also predictive of patient's outcome (death or survival).
本研究旨在评估急性病住院老年患者的营养不良患病率，并通过微型营养评定法（MNA）量表评估入院时标准化营养评估的临床实用性。
前瞻性研究。
一家大型地区性大学医院。
175例患者（113名女性和62名男性），平均年龄79.7±8.5岁，因急性问题入院。11例患者（6.3%）死亡。
入院时，记录每位患者的人口统计学（年龄、性别、来源）和医学（疾病、药物）数据；进行MNA问卷调查（评分：0 - 30）并计算Katz评分（7 - 28）。出院时，数据包括Katz评分、结局（死亡/存活）和去向。
MNA平均评分为20.5±5.1，重度营养不良（MNA＜17）患病率为21.7%。此外，48.6%的老年人存在营养不良风险（MNA在17至24之间）。MNA与年龄或性别之间无关联，但体重过轻是MNA值低的一个迹象（P＜0.001）。入院和出院时MNA评分均与Katz评分呈负相关（P＜0.001）。来自养老院的患者营养状况比居家患者差（MNA：18.4对22.3，P＜0.001）。发现每位患者服用的药物数量（5.2±2.8）与MNA相关（P = 0.049）。存活者的MNA评分平均显著高于非存活者（20.9对14.1，P＜0.001）。
该研究清楚地表明了营养不良的高患病率以及MNA量表在老年医学中的临床实用性。入院时的MNA评分反映了患者的营养状况、自主程度（Katz评分）、生活条件和当前治疗情况。它还可预测患者的结局（死亡或存活）。
