Martins Aline Stangherlin, Rezende Nilton Alves de, Torres Henrique Oswaldo da Gama
UFMG, Belo Horizonte, MG, Brasil.
Rev Assoc Med Bras (1992). 2012 Nov-Dec;58(6):691-7. doi: 10.1590/s0104-42302012000600014.
To evaluate the occurrence of complications, as well as the survival rates, in elderly people having neurological diseases and undergoing enteral nutrition therapy (ENT).
Patients aged over 60 years, assisted by a home medical service from a healthcare plan in the city of Belo Horizonte, MG, Brazil, were thoroughly evaluated. The mentioned evaluation occurred at their homes after hospital discharge with enteral nutrition (EN) after a three-month period, a six-month period, and at the end of the study. A nutritional assessment was performed along with data collection performed on the patients' electronic medical records, and interviews performed with patients' family members and caregivers.
Seventy-nine patients aged 82.9 ± 10.4 years old were evaluated; of these, 49.4% presented dementia, and 50.6% presented other neurological diagnoses. 100% of patients presented a high dependence level, assessed by the Katz index. The majority of patients (91.2%) presented some complications such as: pneumonia, catheter loss, diarrhea, constipation, vomiting, fluid leakage, periostotomy, tube obstruction, reflux, and myiasis. Pneumonia was the most frequent complication, occurring in 55.9% of cases. The mortality rates were 15.2% at a three-month period, 22.8% at a six-month period, and 43% at the end of study. The median survival after starting EN was 364 days. Differences among the mortality rate and neurological diagnosis, EN routes of access, and complications were not observed. The survival rate was lower in patients having inadequate nutritional status and albumin levels < 3.5 mg/dL.
The population followed presented a high rate of complications and death at the end of the study. Diagnosis of dementia, EN routes of access, as well as complications, did not influence the survival rates. However, inadequate nutritional status according to the clinical assessment and albumin levels lower than 3.5 mg/dL significantly influenced the survival rates.
评估患有神经系统疾病并接受肠内营养治疗（ENT）的老年人并发症的发生率以及生存率。
对年龄超过60岁、由巴西米纳斯吉拉斯州贝洛奥里藏特市一家医疗保健计划的家庭医疗服务机构提供协助的患者进行全面评估。上述评估在患者出院后三个月、六个月以及研究结束时在其家中进行肠内营养（EN）时进行。进行了营养评估，并收集患者电子病历中的数据，同时与患者家属和护理人员进行访谈。
评估了79名年龄为82.9±10.4岁的患者；其中，49.4%患有痴呆症，50.6%患有其他神经系统诊断疾病。根据Katz指数评估，100%的患者表现出高度依赖。大多数患者（91.2%）出现了一些并发症，如：肺炎、导管脱落、腹泻、便秘、呕吐、液体渗漏、造口周围炎、导管阻塞、反流和蝇蛆病。肺炎是最常见的并发症，发生率为55.9%。三个月时的死亡率为15.2%，六个月时为22.8%，研究结束时为43%。开始EN后的中位生存期为364天。未观察到死亡率与神经系统诊断、EN接入途径和并发症之间的差异。营养状况不佳且白蛋白水平<3.5mg/dL的患者生存率较低。
在研究结束时，所跟踪的人群出现了高并发症率和死亡率。痴呆症诊断、EN接入途径以及并发症并未影响生存率。然而，根据临床评估营养状况不佳以及白蛋白水平低于3.5mg/dL显著影响了生存率。
