Donini L M, Savina C, Rosano A, De Felice M R, Tassi L, De Bernardini L, Pinto A, Giusti A M, Cannella C
Istituto Nazionale di Statistica, Rome, Italy. Lorenzomaria.Donini @ uniroma1.it
J Nutr Health Aging. 2003;7(5):282-93.
The aim of this study is to verify, in a sample of elderly subjects admitted to long-term care, the impact of malnutrition, according to the Mini Nutritional Assessment (MNA), on mortality and on the occurrence of Adverse Clinical Events in a 3-12 months follow-up study.
The survey included all patients admitted to a geriatric hospital--"Villa delle Querce", Nemi (Rome, Italy)--between January 1997 and April 2000, whose nutritional status we were able to monitor for over 3 months. The study comprised 167 elderly subjects, of which 125 women (74.9%) aged 83.3 8 years (60-95 years), and 42 men (25.1%) aged 79.6 9 years with an average follow-up period of 7.5 months.
Upon admission and at every check we evaluated each subject's cognitive functions, functional status, co-morbidity, frailty, nutritional status (anthropometric and biochemical indices; MNA). During the follow-up we recorded Adverse Clinical Events. We calculated the predictive value of MNA, we correlated variations in MNA scores with variations of nutritional parameters.
MNA's predictive ability both upon admission and upon discharge was found to be excellent. The MNA score was found to be correlated-although not to a very high degree-with variations nutritional parameters. Even more than malnutrition, a low MNA score was found to be predictive of a greater incidence of Adverse Clinical Events during hospitalisation and of higher mortality.
本研究旨在对入住长期护理机构的老年受试者样本进行验证,依据微型营养评定法(MNA)评估营养不良在3至12个月随访研究中对死亡率及不良临床事件发生情况的影响。
该调查涵盖了1997年1月至2000年4月期间入住奈米(意大利罗马)“Villa delle Querce”老年医院的所有患者,这些患者的营养状况我们能够监测超过3个月。该研究包括167名老年受试者,其中125名女性(74.9%),年龄为83.3±8岁(60 - 95岁),42名男性(25.1%),年龄为79.6±9岁,平均随访期为7.5个月。
入院时及每次检查时,我们评估了每位受试者的认知功能、功能状态、合并症、虚弱程度、营养状况(人体测量和生化指标;MNA)。在随访期间,我们记录了不良临床事件。我们计算了MNA的预测价值,将MNA评分的变化与营养参数的变化进行了关联。
发现入院时及出院时MNA的预测能力均极佳。发现MNA评分与营养参数的变化存在相关性——尽管程度不是非常高。发现低MNA评分比营养不良更能预测住院期间不良临床事件的更高发生率及更高的死亡率。