意大利的营养护理常规：来自 PIMAI（项目：意大利医源性营养不良）研究的结果。

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study.

机构信息

International Center for the Assessment of Nutritional Status (ICANS)-Dipartimento di Scienze e Tecnologie Alimentari e Microbiologiche (DISTAM), Università degli Studi di Milano, Milano, Italy.

出版信息

Eur J Clin Nutr. 2010 Aug;64(8):894-8. doi: 10.1038/ejcn.2010.85. Epub 2010 May 26.

DOI:10.1038/ejcn.2010.85

PMID:20502467

Abstract

BACKGROUND/OBJECTIVES: Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies.

SUBJECTS/METHODS: Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) <18.5 kg/m(2) or significant weight loss (>or=10% in 3 months and/or >or=5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected).

RESULTS

In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; P<0.001).

CONCLUSION

Present results confirm that in Italy, nutritional care routines are still poor and need improvements.

摘要

背景/目的：疾病相关的营养不良是入院时常见的合并症。本报告的目的是描述在 Project: Iatrogenic MAlnutrition in Italy (PIMAI) 研究中收集的营养护理常规数据，因为这些数据可能有助于避免医源性营养不良和改善营养政策。

受试者/方法：根据以下标准评估营养护理标准：（1）是否遵守研究方案（收集数据的完整性）；（2）评估营养状况的态度；（3）至少在有明显营养不良（体重指数（BMI）<18.5kg/m² 或体重显著下降（3 个月内>10%和/或过去 1 个月内>5%）的患者中，在 3 天内开具营养治疗处方（无论其是否适当），并遵守当前指南；（4）在住院期间监测营养状况的态度（与预期相比，进行体重测量的次数）。

结果

共评估了 1583 名患者。1284 名患者（81.1%）有进行营养风险筛查 2002 工具的最小数据集，但可以通过与食物摄入、人体测量和生物化学相关的替代分析标准对每位患者进行营养筛查。然而，记录了许多缺失值，特别是由于入院病房未开处方而导致生化参数缺失。根据病房的惯例，只有 38.2%的患者计算了 BMI。仅对 191 名有明显营养不良（26/191 名患者）的患者开具了营养支持。最后，我们记录到仅 21.6%（随机选择的 207/960 名患者）的患者按计划监测体重。这一现实在外科科室比内科科室更差（17%比 26%；P<0.001）。