Sullivan D H, Walls R C, Lipschitz D A
Geriatric Research Education and Clinical Center, John L. McClellan Memorial Veterans Hospital, Little Rock, AR 72205.
Am J Clin Nutr. 1991 Mar;53(3):599-605. doi: 10.1093/ajcn/53.3.599.
To determine whether undernourished elderly patients are at increased risk for mortality, independent of nonnutritional factors affecting outcomes, 109 patients were evaluated at admission to a geriatric rehabilitation unit (GRU) and then followed prospectively for 1 y after hospital discharge. During the interval of observation, 33 (30%) patients died, 11 before hospital discharge and 22 within the year subsequent to discharge. Of the 81 nutritional and nonnutritional variables analyzed, the best predictor of mortality, as determined by stepwise-discriminant-function analysis, within 1 y of hospital discharge was the percent of usual body weight lost in the year previous to admission, followed by the subscapular skinfold thickness and the discharge Katz Index of Activities of Daily Living (ADL) score. Percent of weight lost was also the strongest predictor of 1-y post-GRU-admission mortality. These results provide compelling evidence for the importance of nutritional status in predicting both in-hospital and postdischarge mortality in a population of frail, male GRU patients.
为了确定营养不良的老年患者是否存在更高的死亡风险，且独立于影响预后的非营养因素，我们对109名入住老年康复单元（GRU）的患者在入院时进行了评估，并在出院后对他们进行了为期1年的前瞻性随访。在观察期内，33名（30%）患者死亡，其中11名在出院前死亡，22名在出院后的一年内死亡。在分析的81个营养和非营养变量中，通过逐步判别函数分析确定，出院后1年内死亡的最佳预测指标是入院前一年体重丢失占平时体重的百分比，其次是肩胛下皮褶厚度和出院时的Katz日常生活活动能力指数（ADL）评分。体重丢失百分比也是GRU入院后1年死亡率的最强预测指标。这些结果为营养状况在预测虚弱男性GRU患者群体的住院和出院后死亡率方面的重要性提供了有力证据。
