住院患儿的营养风险筛查及其临床意义。
Nutritional risk screening and its clinical significance in hospitalized children.
机构信息
Department of Child Health Care, Nanjing Children's Hospital, Affiliated with Nanjing Medical University, 72 Guangzhou Road, Nanjing 210008, China.
Department of Nutrition, The Publication Health College of Nanjing Medical University, Nanjing, China.
出版信息
Clin Nutr. 2014 Jun;33(3):432-6. doi: 10.1016/j.clnu.2013.06.009. Epub 2013 Jul 1.
BACKGROUND & AIMS: To analyse nutritional risk in hospitalized children and its relationship with clinical outcomes to provide evidence for improved nutritional management.
METHODS
The investigation involved 1325 consecutively enrolled hospitalized children from Nanjing Children's Hospital. The nutritional risks in the hospitalized children were evaluated using the STRONGkids tool. During hospitalization, the incidence of infectious complications, length of hospital stay, weight loss, hospital expenses and nutritional support were recorded.
RESULTS
The percentages of children with high, moderate and low nutritional risk were 9.1% (121), 43.3% (574) and 47.6% (630), respectively. Children with cardiac, respiratory or oncologic disease were most likely to have high nutritional risk. STRONGkids scores were correlated with clinical outcome. Higher complication rates, longer stay lengths, greater weight loss and greater hospital expenses were observed in children with high nutritional risk compared to those with moderate or low risk (p < 0.001). Nutritional support during hospitalization was given to 62.8% (76) of children with high nutritional risk, 18.6% (107) of children with moderate nutritional risk and 8.9% (56) of children with low nutritional risk.
CONCLUSIONS
Hospitalized children exposed to high or moderate nutritional risks have poor clinical outcomes. Nutritional support is not yet performed appropriately. Evidence-based guidelines should be created to improve this situation.
背景与目的
分析住院患儿的营养风险及其与临床结局的关系，为改善营养管理提供依据。
方法
采用 STRONGkids 工具对南京儿童医院 1325 例连续住院患儿进行营养风险评估，记录住院期间感染并发症发生率、住院时间、体质量丢失、住院费用及营养支持情况。
结果
高、中、低营养风险患儿分别占 9.1%（121 例）、43.3%（574 例）和 47.6%（630 例）。患有心脏、呼吸或肿瘤疾病的患儿最有可能存在高营养风险。STRONGkids 评分与临床结局相关。与中、低营养风险患儿相比，高营养风险患儿的并发症发生率更高、住院时间更长、体质量丢失更多、住院费用更高（p<0.001）。1325 例患儿中，62.8%（76 例）的高营养风险患儿、18.6%（107 例）的中营养风险患儿和 8.9%（56 例）的低营养风险患儿接受了营养支持。
结论
存在高或中营养风险的住院患儿临床结局较差，营养支持尚不合理，应制定基于证据的指南来改善这一情况。
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