Thomas D R, Kamel H, Azharrudin M, Ali A S, Khan A, Javaid U, Morley J E
Division of Geriatric Medicine, Saint Louis Health Sciences Center and, GRECC, Veterans Administration Center, MO 63104, USA.
J Nutr Health Aging. 2005;9(3):169-75.
Prediction of in-hospital mortality may direct hospital resources towards those patients most at risk. A number of single domain risk instruments have been developed, indicating that functional status, nutritional assessment, and severity of illness individually predict in-hospital mortality. The interaction among these predictors is less well described.
To determine the relationship of functional status, nutritional assessment, and severity of illness to in-hospital mortality.
DESIGN, SETTING, SUBJECTS: Cohort study of 1712 consecutive admissions over a one year period to an Internal Medical Service at a tertiary university teaching hospital.
Death during hospital admission.
Dependency in activities of daily living (OR = 3.37, 95% CI 1.78 to 6.37, p = 0.0002) and body mass index less than 20 (OR = 2.38, 95% CI 1.20 to 4.74, p = 0.01) predicted in-hospital mortality after adjusting for nutritional risk assessment, and severity of illness score.
Impairment in functional status and low body mass index produce the best predictors of inhospital mortality, after adjusting for nutritional risk and severity of illness score. Among these factors, functional impairment may be amenable to correction.
预测住院死亡率可将医院资源导向风险最高的患者。已经开发了许多单领域风险工具，表明功能状态、营养评估和疾病严重程度各自可预测住院死亡率。这些预测因素之间的相互作用描述得较少。
确定功能状态、营养评估和疾病严重程度与住院死亡率之间的关系。
设计、设置、研究对象：对一所三级大学教学医院内科服务部一年内连续收治的1712例患者进行队列研究。
住院期间死亡。
在调整营养风险评估和疾病严重程度评分后，日常生活活动依赖（比值比=3.37，95%可信区间1.78至6.37，p=0.0002）和体重指数低于20（比值比=2.38，95%可信区间1.20至4.74，p=0.01）可预测住院死亡率。
在调整营养风险和疾病严重程度评分后，功能状态受损和低体重指数是住院死亡率的最佳预测因素。在这些因素中，功能障碍可能可以纠正。
