Thomas J M, Isenring E, Kellett E
Department of Nutrition and Dietetics, Flinders University, Bedford Park, Adelaide, SA 5041, Australia.
J Hum Nutr Diet. 2007 Aug;20(4):320-8. doi: 10.1111/j.1365-277X.2007.00765.x.
The Redesigning Care initiative at Flinders Medical Centre aimed to improve access to timely, consistent, quality care. This led to the creation of an Acute Assessment Unit (AAU) where all patients are assessed by the Allied Health team on admission. This study aimed to: (i) determine the nutritional status of patients admitted to the AAU using the scored Patient Generated-Subjective Global Assessment (PG-SGA); and (ii) determine the association between nutritional status and length of stay (LOS).
A prospective, observational study was conducted in 64 patients (mean age 79.9 +/- 11 years, 76% female). Nutritional status was assessed within 48 h of admission and LOS data were collected prospectively.
According to PG-SGA global rating, 53% (n = 34) of patients were malnourished. There was a weak association between PG-SGA score and LOS (r = 0.250, P = 0.046). The malnourished patients had a longer LOS by 1 day compared to well-nourished patients, and while this did not reach statistical significance (Z = -0.988, P = 0.323), it has implications for health care costs. LOS overall was short at a median of 4.5 days (range 1-24).
A significant proportion of patients admitted to the AAU is malnourished. There was a trend for these patients to have a longer LOS, indicating a critical need for nutritional management; however LOS as a whole was short. While nutrition support in hospital is useful in reinforcing dietary education, the short LOS emphasized the importance of discharge education and follow-up.
弗林德斯医疗中心的“重新设计护理”倡议旨在改善及时、持续、优质护理的可及性。这促成了急性评估单元（AAU）的设立，所有患者入院时均由联合健康团队进行评估。本研究旨在：（i）使用评分的患者主观整体评定法（PG-SGA）确定入住AAU患者的营养状况；（ii）确定营养状况与住院时间（LOS）之间的关联。
对64例患者（平均年龄79.9±11岁，76%为女性）进行了一项前瞻性观察研究。入院后48小时内评估营养状况，并前瞻性收集LOS数据。
根据PG-SGA总体评分，53%（n = 34）的患者营养不良。PG-SGA评分与LOS之间存在弱关联（r = 0.250，P = 0.046）。与营养良好的患者相比，营养不良的患者LOS长1天，虽然这未达到统计学意义（Z = -0.988，P = 0.323），但对医疗成本有影响。总体LOS较短，中位数为4.5天（范围1 - 24天）。
入住AAU的患者中有很大一部分营养不良。这些患者有LOS较长的趋势，表明营养管理至关重要；然而总体LOS较短。虽然医院的营养支持有助于加强饮食教育，但LOS较短强调了出院教育和随访的重要性。
