Lamb Christopher A, Parr John, Lamb Elizabeth I M, Warren Matthew D
Department of Gastroenterology, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear NE29 8NH, UK.
Br J Nutr. 2009 Aug;102(4):571-5. doi: 10.1017/S0007114509236038. Epub 2009 Feb 10.
The objectives of the present cross-sectional study were to assess the screening, prevalence and management of malnutrition and identify any co-existence with obesity in adult hospital in-patients. The Malnutrition Universal Screening Tool (MUST) was applied to all medical, surgical, orthopaedic and critical care in-patients in an acute hospital in North-East England on a single day in 2007. An audit was also performed of malnutrition screening using a locally developed tool. Patients were excluded from study if they had been an in-patient less than 24 h or if discharged on the day of study. Of 328 patients meeting inclusion criteria, 100% had full data collection (143 males, 185 females, median length of stay 8 d (range 1-90 d), median age 76 years (range 17-101 years)). Only 226 patients (68.9%) had been screened for malnutrition and thirty-one (13.7%) were at highest malnutrition risk, of which only 45.2% were appropriately referred to nutrition and dietetic services. The prevalence of malnutrition (MUST > or = 1) was 44%. The prevalence of highest risk (MUST > or = 2) increased with age (20.6% < 60 years, 29.7% 60-79 years and 39.4% > or = 80 years). In total 37.8% (n 70) of female patients had a MUST score of > or = 2 compared with 24.5% (n 35) of males. Obesity (BMI > 30 kg/m2) was identified in 9.5% of those with a MUST score > or = 2. We have shown that malnutrition is a common problem affecting over 40% of patients in this hospital-wide study. Currently malnutrition is often unrecognised and undertreated in clinical practice. Hospitals must develop comprehensive strategies to both identify and treat in-patients with this common condition.
本横断面研究的目的是评估成年住院患者营养不良的筛查、患病率及管理情况，并确定其与肥胖并存的情况。2007年的某一天，营养不良通用筛查工具（MUST）被应用于英格兰东北部一家急症医院的所有内科、外科、骨科及重症监护住院患者。同时还使用当地开发的工具对营养不良筛查进行了审计。如果患者住院时间不足24小时或在研究当天出院，则被排除在研究之外。在符合纳入标准的328名患者中，100%完成了数据收集（男性143名，女性185名，中位住院时间8天（范围1 - 90天），中位年龄76岁（范围17 - 101岁））。仅有226名患者（68.9%）接受了营养不良筛查，其中31名（13.7%）处于最高营养不良风险，而这些患者中只有45.2%被适当地转介至营养和饮食服务部门。营养不良（MUST≥1）的患病率为44%。最高风险（MUST≥2）的患病率随年龄增长而增加（<60岁为20.6%，60 - 79岁为29.7%，≥80岁为39.4%）。总计37.8%（n = 70）的女性患者MUST评分≥2，而男性患者为24.5%（n = 35）。在MUST评分≥2的患者中，9.5%被确定为肥胖（BMI>30 kg/m²）。我们已经表明，在这项全院范围的研究中，营养不良是一个影响超过40%患者的常见问题。目前，在临床实践中，营养不良常常未被识别且治疗不足。医院必须制定全面的策略来识别和治疗患有这种常见病症的住院患者。
