1] National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK [2] School of Health Sciences, City University, London, UK [3] Centre for Gastroenterology and Clinical Nutrition, University College, London, UK.
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
Eur J Clin Nutr. 2014 Jan;68(1):125-30. doi: 10.1038/ejcn.2013.238. Epub 2013 Nov 20.
BACKGROUND/OBJECTIVES: To evaluate whether undernutrition risk measured using the Spinal Nutrition Screening Tool (SNST) and the Malnutrition Universal Screening Tool (MUST) is associated with worse clinical outcomes in respect of length of in-patient hospital stay (LOS) and mortality in the 12 months after admission to a spinal cord injuries (SCIs) centre.
A multicentre, prospective, cross-sectional observational study was conducted in four UK SCI centres (SCICs). A total of 150 SCI patients (aged 18-88 years (median: 44 years), 30.7% females) were studied between July 2009 and March 2010. LOS and mortality 12 months after admission to the SCIC was monitored. Multivariate regression analysis was used to identify unique predictors of the variance of LOS.
The patients initially undernourished or at risk of undernutrition (44.6%) had a significantly longer LOS (median (days): 129 vs 85, P=0.012) and greater 12-month mortality (% deceased: 9.2% vs 1.4%, P=0.036). In addition, serum albumin and new admission to an SCIC were identified as independent predictors for long LOS.
The present study suggests that undernutrition risk, as identified by the SNST, is associated with adverse clinical outcomes. Nutritional screening should be helpful in improving clinical outcomes if it promotes more appropriate and effective nutritional intervention.
背景/目的：评估使用脊柱营养筛查工具（SNST）和营养不良通用筛查工具（MUST）测量的营养风险与住院时间（LOS）和入院后 12 个月死亡率等临床结局较差是否相关在脊髓损伤（SCI）中心。
在四个英国 SCI 中心（SCIC）进行了一项多中心、前瞻性、横断面观察性研究。2009 年 7 月至 2010 年 3 月期间研究了 150 名 SCI 患者（年龄 18-88 岁（中位数：44 岁），女性占 30.7%）。监测入院后 12 个月的 LOS 和死亡率。采用多元回归分析确定 LOS 方差的独特预测因子。
最初存在营养不良或存在营养不良风险的患者（44.6%）的 LOS 明显更长（中位数（天）：129 与 85，P=0.012），12 个月死亡率更高（%死亡：9.2%与 1.4%，P=0.036）。此外，血清白蛋白和 SCI 中心新入院被确定为 LOS 长的独立预测因子。
本研究表明，SNST 确定的营养风险与不良临床结局相关。如果营养筛查能够促进更适当和有效的营养干预，那么它可能有助于改善临床结局。
