Waitzberg Dan L, Correia Maria Isabel T D
Gastroenterology Department, University of São Paulo Medical School, Brazil.
Curr Opin Clin Nutr Metab Care. 2003 Sep;6(5):531-8. doi: 10.1097/00075197-200309000-00006.
Malnutrition is highly prevalent in hospitalized patients. Despite this, it is not routinely assessed in most hospitals worldwide. One of the reasons that might explain this fact is that there is no gold-standard nutritional assessment tool, and much has been written advocating this or that technique. The main topic of this review is discussion of the advantages and disadvantages of each of the available tools.
Several studies have recently reinforced the relationship between poor nutritional status and higher incidences of complications, mortality, length of hospital stay and costs. Therefore, it is of the utmost importance to be able to diagnose malnutrition early.
The evaluation of nutritional status is a broad topic that encompasses several clinical variables. In order to be ideal, the method should be able to predict patient outcome, should be able to be performed by most care-givers, should be inexpensive, and should not be time-consuming. Unfortunately, most nutritional assessment instruments were published with insufficient details regarding their intended use and method of derivation, and with an inadequate assessment of their effectiveness. Therefore, health professionals should be critical when defining which instrument should be adopted by an institution, and several factors should be taken into consideration.
营养不良在住院患者中极为普遍。尽管如此,全球大多数医院并未对其进行常规评估。造成这一现象的原因之一可能是缺乏金标准的营养评估工具,关于采用何种技术的相关论述众多。本综述的主要主题是探讨每种现有工具的优缺点。
近期多项研究进一步证实了营养状况不佳与并发症、死亡率、住院时间及费用发生率升高之间的关联。因此,能够早期诊断营养不良至关重要。
营养状况评估是一个涵盖多个临床变量的广泛议题。理想的评估方法应能够预测患者预后,多数护理人员均可操作,成本低廉且不耗时。遗憾的是,多数营养评估工具在发表时,关于其预期用途、推导方法的细节不足,且对其有效性评估不充分。因此,卫生专业人员在确定机构应采用何种工具时应持审慎态度,并应考虑多个因素。