Kim Eun Joo, Yoon Yong Hoon, Kim Wan Ho, Lee Kwang Lae, Park Jeong Mi
Department of Physical Medicine & Rehabilitation, National Rehabilitation Center, Seoul, Korea.
Ann Rehabil Med. 2013 Feb;37(1):66-71. doi: 10.5535/arm.2013.37.1.66. Epub 2013 Feb 28.
To evaluate the clinical usefulness of the subjective assessments of nutritional status (Mini-Nutritional Assessment [MNA] and scored patient-generated subjective global assessment [PG-SGA]), compared with the objective (hematological, biochemical, and anthropometric) assessments, and to identify the correlation between the MNA and the scored PG-SGA in elderly patients with stroke.
Thirty-five stroke patients, aged 60 to 89 years old, participated in our study. The MNA, the scored PG-SGA and objective factors were evaluated. The objective malnutrition state was defined based on laboratory outcomes. According to the MNA and the scored PG-SGA classifications, total patients were respectively divided into three groups; well-nourished (W), at risk of malnutrition (R), and malnourished (M), and into four groups; normally nourished (A), suspected or mildly malnourished (B), moderately malnourished (C), and severely malnourished (D).
Mean age and body mass index of subjects were 70.6 years and 22.2 kg/m(2), respectively. Twenty-six (74.3%) patients were identified to be at an objectively malnourished state. In MNA, 3 (8.6%) patients were classified as group W, 13 (37.1%) as R, and 19 (54.3%) as M. Total MNA scores and three categorization had mild correlation with objective grouping (r=0.383, r=0.350, p<0.05, respectively). Restructuring into two groups by combining group R and M made strong correlation (r=0.520, p<0.01). On the basis of scored PG-SGA, 6 (17.1%) patients were sorted as group A, 10 (28.6%) as B, 15 (42.9%) as C, and 4 (11.4%) as D, respectively. Total scores and the grouping into four indicated meaningful correlation with the objective distinction (r=-0.403, p<0.05, r=0.449, p<0.01, respectively). There was a significant correlation between the MNA scores and the PG-SGA scores (r=-0.651, p<0.01).
It is proposed that the MNA and the scored PG-SGA would be useful in screening malnourished elderly patients with stroke.
评估营养状况主观评估方法（微型营养评定法[MNA]和评分患者主观全面评定法[PG-SGA]）与客观评估方法（血液学、生化和人体测量学评估方法）相比的临床实用性，并确定老年卒中患者中MNA与评分PG-SGA之间的相关性。
35例年龄在60至89岁之间的卒中患者参与了本研究。对MNA、评分PG-SGA和客观因素进行了评估。根据实验室检查结果定义客观营养不良状态。根据MNA和评分PG-SGA的分类，将所有患者分别分为三组：营养良好（W）、营养不良风险（R）和营养不良（M）；以及四组：营养正常（A）、疑似或轻度营养不良（B）、中度营养不良（C）和重度营养不良（D）。
受试者的平均年龄和体重指数分别为70.6岁和22.2kg/m²。26例（74.3%）患者被确定处于客观营养不良状态。在MNA中，3例（8.6%）患者被归类为W组，13例（37.1%）为R组，19例（54.3%）为M组。MNA总分及三种分类与客观分组有轻度相关性（r分别为0.383、0.350，p<0.05）。将R组和M组合并为两组后相关性增强（r=0.520，p<0.01）。基于评分PG-SGA，6例（17.1%）患者被分类为A组，10例（28.6%）为B组，15例（42.9%）为C组，4例（11.4%）为D组。总分及分为四组与客观分类有显著相关性（r分别为-0.403，p<0.05；r=0.449，p<0.01）。MNA评分与PG-SGA评分之间存在显著相关性（r=-0.651，p<0.01）。
建议MNA和评分PG-SGA在筛查营养不良的老年卒中患者中有用。
