Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
Br J Nutr. 2012 Sep;108(5):918-23. doi: 10.1017/S0007114511006234. Epub 2011 Dec 15.
Data on the prevalence of malnutrition among patients with spinal cord injuries (SCI) are lacking. The aim of the present study was to assess nutritional risk at admission, and the status of nutritional support in the UK SCI Centres (SCIC); a cross-sectional, multicentre study in four SCIC. A standardised questionnaire was used and distributed to the participating SCIC. After obtaining informed consent, baseline demographic data, nutritional risk score by the 'Malnutrition Universal Screening Tool', BMI and routine blood biochemistry were collected from every patient admitted to an SCIC. The four SCIC, comprising 48·2 % of the total UK SCI beds, contributed data from 150 patients. On admission, 44·3 % of patients were malnourished or at risk of undernutrition. Nutritional risk was more common in patients with acute high cervical SCI than those with lower SCI (60·7 v. 34·5 %), and nutritional risk was more common in those with additional complications including ventilatory support (with tracheostomy, 56·3 v. 38·7 %). Also, 45 % of patients were at risk of overnutrition (BMI ≥ 25 kg/m2). The prevalence of malnutrition in SCI patients admitted to SCIC is higher than national figures focused on general hospitalised patients, indicating that SCI patients are particularly vulnerable to malnutrition. Patients with SCI who have a tracheostomy may need additional attention. Given the potential negative impact of malnutrition on clinical outcomes, an emphasis on mandatory nutrition screening, followed by detailed assessment for at-risk individuals should be in place in the SCIC.
目前缺乏有关脊髓损伤(SCI)患者营养不良患病率的数据。本研究旨在评估英国 SCI 中心(SCIC)入院时的营养风险,并评估营养支持的状况;这是一项在四个 SCIC 中进行的横断面、多中心研究。使用标准化问卷并分发给参与的 SCIC。在获得知情同意后,从每个入住 SCIC 的患者中收集基线人口统计学数据、“营养不良通用筛查工具”的营养风险评分、BMI 和常规血液生化指标。四个 SCIC 占英国 SCI 床位总数的 48.2%,提供了来自 150 名患者的数据。入院时,44.3%的患者存在营养不良或存在营养不足风险。急性高颈段 SCI 患者的营养风险高于低段 SCI 患者(60.7%比 34.5%),且存在包括通气支持在内的其他并发症的患者的营养风险更高(带气管造口术的患者为 56.3%,比 38.7%)。此外,45%的患者有超重风险(BMI≥25kg/m2)。入住 SCIC 的 SCI 患者的营养不良患病率高于关注一般住院患者的全国数据,这表明 SCI 患者特别容易发生营养不良。有气管造口术的 SCI 患者可能需要额外关注。鉴于营养不良对临床结局的潜在负面影响,SCIC 应强调强制性营养筛查,然后对高危人群进行详细评估。