Compher Charlene, Cato Robert, Bader Joan, Kinosian Bruce
School of Nursing, Health System, and Department of Clinical Nutrition Support, University of Pennsylvania, Philadelphia, PA 19104-6096, USA.
J Natl Med Assoc. 2004 Feb;96(2):209-14.
Malnutrition, associated with poor outcome in the elderly, may be exacerbated by weight loss during hospitalization. Accurate estimation of energy requirements is important, particularly if predictions are applied to caloric supply. Because data on energy requirements for the elderly are limited, particularly for African-American patients, predictions are commonly made with equations derived from a younger, caucasian, cohort from 80 years ago.
To compare measured resting metabolic rate (RMR) in a hospitalized elderly African-American cohort in an urban community hospital during 1998 with Harris-Benedict predictions of basal energy expenditure (BEE). Energy expenditure was measured by a strict protocol with a portable metabolic cart, and height and weight were measured standardly and used to calculate BEE and body mass index (BMI).
In 61 subjects, aged 79.6+/-8.9 years, measured RMR was significantly greater than predicted BEE (p=0.001, t-test). Caloric expenditure averaged 24.7+/-5 kcal/kg/day, but the range was broad (14-39 kcal/kg/day). The BEE prediction was 20.3+/-2.4 kcal/kg/day.
In elderly hospitalized African-American patients, the Harris-Benedict equation significantly underestimated energy requirements. Given the link between unintentional weight loss and increased mortality on the one hand and potential clinical complications of overfeeding on the other, measurement of energy expenditure is warranted.
营养不良与老年人预后不良相关，住院期间体重减轻可能会加剧这种情况。准确估计能量需求很重要，特别是当预测用于热量供应时。由于关于老年人能量需求的数据有限，尤其是非裔美国患者，通常使用80年前来自年轻白种人队列推导的公式进行预测。
比较1998年在一家城市社区医院住院的老年非裔美国人群体中测量的静息代谢率（RMR）与哈里斯-本尼迪克特基础能量消耗（BEE）预测值。通过严格方案使用便携式代谢推车测量能量消耗，标准测量身高和体重并用于计算BEE和体重指数（BMI）。
在61名年龄为79.6±8.9岁的受试者中，测量的RMR显著高于预测的BEE（p = 0.001，t检验）。热量消耗平均为24.7±5千卡/千克/天，但范围较宽（14 - 39千卡/千克/天）。BEE预测值为20.3±2.4千卡/千克/天。
在住院的老年非裔美国患者中，哈里斯-本尼迪克特方程显著低估了能量需求。鉴于非故意体重减轻与死亡率增加之间的联系，以及过度喂养的潜在临床并发症，有必要测量能量消耗。
