Galvan Oliver, Joannidis Michael, Widschwendter Andreas, Bonatti Hugo, Sprinzl Georg Matthias, Rehak Peter, Balogh Doris, Hackl Johann Michael
Department of Otorhinolaryngology, Innsbruck University Hospital, Innsbruck, Austria.
Wien Klin Wochenschr. 2004 Sep 30;116(17-18):596-602. doi: 10.1007/s00508-004-0224-8.
Despite intense clinical research, no commonly accepted diagnostic tool for assessment of nutritional status is yet available. In this study a comparison of four different methods for diagnosis of the nutritional status of patients admitted to a university hospital in Austria is presented.
Clinical data of 640 hospitalised patients were analysed in a prospective-descriptive study design. Four recommended methods, the Innsbruck nutrition score (INS), the Prideaux nutritional risk assessment (PNRA), the well established nutrition risk index (NRI), and the body mass index (BMI) were used to analyse nutritional status.
The BMI showed 90.2% of the patients evaluated to have normal nutritional status, whereas the PNRA identified 48.9%, the NRI 40% and the INS 58.6% as well nourished. Patients were variously diagnosed with moderate malnutrition: 9% (BMI), 42% (PNRA), 54.8% (NRI) and 30% (INS). Severe malnutrition was detected in 0.5% (BMI), 9.1% (PNRA), 5.2% (NRI) and 11.4% (INS) of the patients evaluated. Cancer patients had the worst nutritional status.
Malnutrition seems to be a common diagnosis among hospitalised patients in Austria. Screening and assessment of nutritional status should be integrated into clinical routine. The methods tested scored malnutrition at different frequencies. BMI seemed to underestimate the prevalence of malnutrition. The PNRA provided some information on clinical outcome, whereas the NRI had the best relationship between the degree of malnutrition and length of stay. Calculation of the INS may give correct diagnosis of severe malnutrition. Further prospective clinical studies are needed to validate the scoring systems used in this study and to provide accurate clinical diagnosis of malnutrition.
尽管进行了大量临床研究，但目前尚无普遍接受的用于评估营养状况的诊断工具。本研究对奥地利一家大学医院收治患者的营养状况诊断的四种不同方法进行了比较。
采用前瞻性描述性研究设计分析了640例住院患者的临床资料。使用四种推荐方法，即因斯布鲁克营养评分（INS）、普里多克斯营养风险评估（PNRA）、成熟的营养风险指数（NRI）和体重指数（BMI）来分析营养状况。
BMI显示90.2%的评估患者营养状况正常，而PNRA识别出48.9%营养良好，NRI为40%，INS为58.6%。患者被不同程度诊断为中度营养不良：BMI为9%，PNRA为42%，NRI为54.8%，INS为30%。在评估患者中，0.5%（BMI）、9.1%（PNRA）、5.2%（NRI）和11.4%（INS）被检测出患有严重营养不良。癌症患者的营养状况最差。
营养不良似乎是奥地利住院患者中的常见诊断。营养状况的筛查和评估应纳入临床常规。所测试的方法对营养不良的评分频率不同。BMI似乎低估了营养不良的患病率。PNRA提供了一些关于临床结局的信息，而NRI在营养不良程度与住院时间之间的关系最佳。INS的计算可能对严重营养不良给出正确诊断。需要进一步的前瞻性临床研究来验证本研究中使用的评分系统，并提供准确的营养不良临床诊断。
