de Luis Daniel A, Izaola Olatz, Cuellar Luis, Terroba M Concepcion, Cabezas Gloria, Rojo S, Aller Rocio, Sagrado M Gonzalez
Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation, Hospital Rio Hortega, University of Valladolid, Valladolid, Spain.
Ann Nutr Metab. 2006;50(4):394-8. doi: 10.1159/000094362. Epub 2006 Jun 30.
Studies indicate that 40-50% of hospitalized patients show malnutrition, a variable that is associated with length of stay and morbidity. The aim of our study was to detect nutritional parameters, which could have an influence on length of stay in hospitalized patients.
All patients with a nutritional evaluation at hospital admission were elegible for inclusion. A total of 1,088 patients were studied from January 1999 to December 2003. Length of stay (LOS) data was obtained from the patient hospital record after the patient was discharged. All patients received instruction in 24-hour written food record keeping. Albumin, prealbumin, transferrin, glucose levels and total lymphocytes, were measured in all patients. Weight, body mass index, tricipital skinfold, midarm muscle circumference and midarm muscle area were assessed in a standard way. Weight loss in the previous 3 months was recorded.
A total of 1,088 patients were enrolled, mean age 61.8 +/- 17 years, weight 64.2 +/- 15 kg and BMI 23.9 +/- 4.6, with a weight loss 4.15 +/- 9.6 kg. The sex distribution of patients was 65.2% male and 34.8% females. Distribution of diagnosis showed leukemia and lymphoma (11.5%), solid cancer (37.4%), infections (3.5%), neurological disease (13.6%), respiratory tract disease (8.8%), and miscellaneous group (25.3%). Length of stay was 29.45 +/- 25.13 days. In whole group, the correlation analysis among length of stay (days) and predictive parameters showed a positive association between albumin and length of stay (r = -0.2; p < 0.05). In the multivariant analysis with a dependent variable (length of stay (days)) and independent variables with an association in univariant analysis adjusted by age and sex, only albumin remained as an independent predictor in the model (F = 8.8; p < 0.05), with an increase of 6.2 days (95% CI: 3.5-8.9) with each decrease of 1 g/dl of albumin.
The serum albumin levels are a good marker of LOS, a decrease in admission levels produces an increase in LOS.
研究表明，40%-50%的住院患者存在营养不良，这一变量与住院时间和发病率相关。我们研究的目的是检测可能影响住院患者住院时间的营养参数。
所有入院时进行营养评估的患者均符合纳入标准。1999年1月至2003年12月共研究了1088例患者。患者出院后，从其住院记录中获取住院时间（LOS）数据。所有患者均接受了24小时书面饮食记录保存的指导。对所有患者测量白蛋白、前白蛋白、转铁蛋白、血糖水平和总淋巴细胞数。以标准方式评估体重、体重指数、三头肌皮褶厚度、上臂中部肌肉周长和上臂中部肌肉面积。记录前3个月的体重减轻情况。
共纳入1088例患者，平均年龄61.8±17岁，体重64.2±15kg，体重指数23.9±4.6，体重减轻4.15±9.6kg。患者的性别分布为男性65.2%，女性34.8%。诊断分布显示白血病和淋巴瘤（11.5%）、实体癌（37.4%）、感染（3.5%）、神经系统疾病（13.6%）、呼吸道疾病（8.8%）和其他组（25.3%）。住院时间为29.45±25.13天。在整个研究组中，住院时间（天数）与预测参数之间的相关性分析显示白蛋白与住院时间呈正相关（r=-0.2；p<0.05）。在以因变量（住院时间（天数））和单变量分析中有相关性且经年龄和性别调整的自变量进行的多变量分析中，模型中仅白蛋白仍为独立预测因子（F=8.8；p<0.05），白蛋白每降低1g/dl，住院时间增加6.2天（95%CI：3.5-8.9）。
血清白蛋白水平是住院时间长短的良好标志物，入院时白蛋白水平降低会导致住院时间延长。
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