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通过多变量模型分析评估营养不良对发病率、死亡率、住院时间和费用的影响。

The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis.

作者信息

Correia M Isabel T D, Waitzberg Dan L

机构信息

Department of Surgery, Faculdade de Medicina da, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

出版信息

Clin Nutr. 2003 Jun;22(3):235-9. doi: 10.1016/s0261-5614(02)00215-7.

Abstract

Malnutrition has been identified as affecting patient outcome. The purpose of this study was to correlate the nutritional status of hospitalized patients with their morbidity, mortality, length of hospital stay and costs. The patients were nutritionally assessed within the first 72 h of hospital admission. The patients' charts were surveyed on the incidence of complications and mortality. Hospital costs were calculated based on economic tables used by insurance companies. Multivariate logistic regression analysis and the Cox regression model were used to identify possible confounding factors. A P<0.05 was considered statistically significant. The mean age was 50.6+/-17.3 years with 50.2% being male. The incidence of complications in the malnourished was 27.0% [Relative risk (RR)=1.60]. Mortality in the malnourished patients was 12.4% vs 4.7% in the well nourished (RR = 2.63). Malnourished patients stayed in the hospital for 16.7+/-24.5 days vs 10.1+/-11.7 days in the nourished. Hospital costs in malnourished patients were increased up to 308.9%. It was concluded that malnutrition, as analyzed by a multivariate logistic regression model, is an independent risk factor impacting on higher complications and increased mortality, length of hospital stay and costs.

摘要

营养不良已被确认为会影响患者的预后。本研究的目的是将住院患者的营养状况与其发病率、死亡率、住院时间和费用相关联。在患者入院后的72小时内对其进行营养评估。对患者病历进行调查,统计并发症和死亡率的发生率。根据保险公司使用的经济表格计算住院费用。采用多因素逻辑回归分析和Cox回归模型来识别可能的混杂因素。P<0.05被认为具有统计学意义。平均年龄为50.6±17.3岁,男性占50.2%。营养不良患者的并发症发生率为27.0%[相对危险度(RR)=1.60]。营养不良患者的死亡率为12.4%,而营养良好患者的死亡率为4.7%(RR = 2.63)。营养不良患者的住院时间为16.7±24.5天,而营养良好患者为10.1±11.7天。营养不良患者的住院费用增加了308.9%。研究得出结论,通过多因素逻辑回归模型分析,营养不良是一个独立的危险因素,会导致更高的并发症发生率、死亡率、住院时间和费用。

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