Kyle Ursula G, Genton Laurence, Pichard Claude
Department of Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
Curr Opin Clin Nutr Metab Care. 2005 Jul;8(4):397-402. doi: 10.1097/01.mco.0000172579.94513.db.
This review looks at the recent medical literature on the association between hospital length of stay and nutritional status.
Simple anthropometric parameters underestimate the nutritional risk in hospitalized patients. The Malnutrition Universal Screening Tool and Nutritional Risk Screening are simple screening tools that identify patients who require further monitoring. Recent weight loss appears to be the most important single indicator of nutritional status. Body composition measurements identify patients with muscle mass depletion and excess body fat, both of which are significantly associated with increased length of stay. The Subjective Global Assessment is useful at detecting patients with established malnutrition and the Mini Nutritional Assessment for the elderly is useful at detecting patients who need preventive nutritional measures. The Nutritional Risk Index, which incorporates albumin and weight loss, appears to capture both nutritional risk and poor clinical outcome.
Nutritional risk is associated with the length of stay in hospital. The choice of nutritional screening and assessment tools depends on the type of institution (university hospital versus community hospital), the patient populations (acute care versus intermediary care; general hospital versus elderly population) and the resources available.
本综述探讨近期关于住院时长与营养状况之间关联的医学文献。
简单的人体测量参数会低估住院患者的营养风险。营养不良通用筛查工具和营养风险筛查是识别需要进一步监测患者的简单筛查工具。近期体重减轻似乎是营养状况最重要的单一指标。身体成分测量可识别肌肉量减少和体脂过多的患者，这两者均与住院时长增加显著相关。主观全面评定有助于检测已患营养不良的患者，而老年人简易营养评估有助于检测需要预防性营养措施的患者。纳入白蛋白和体重减轻情况的营养风险指数似乎能反映营养风险和不良临床结局。
营养风险与住院时长相关。营养筛查和评估工具的选择取决于机构类型（大学医院与社区医院）、患者群体（急性护理与中间护理；综合医院与老年人群体）以及可用资源。
