Kelaiditi Eirini, Demougeot Laurent, Lilamand Matthieu, Guyonnet Sophie, Vellas Bruno, Cesari Matteo
Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
J Am Med Dir Assoc. 2014 Aug;15(8):588-92. doi: 10.1016/j.jamda.2014.04.012. Epub 2014 Jun 6.
To examine the predictive value of the Mini Nutritional Assessment-short form (MNA-SF) and its individual items on the incidence of pneumonia.
Prospective observational cohort study over 1-year of follow-up.
A total of 773 older persons (74.4% women) living in 13 French nursing homes from the Incidence of pNeumonia and related ConseqUences in nursing home Residents (INCUR) study.
Nutritional status was assessed using the MNA-SF questionnaire at baseline. Diagnosis of pneumonia was based on clinical conditions retrieved from a medical chart. Cox proportional hazard models were applied to test whether the MNA-SF score and its single components predict pneumonia events over 1 year of follow-up.
After 1 year of follow-up, 160 (21%) incident cases of pneumonia were recorded. Mean age of participants was 86.2 (SD 7.5) years. Mean MNA-SF score was 9.8 (SD 2.4), with more than half of the participants (58.7%) being at risk of malnutrition (8-11 points). The total MNA-SF score and its categories did not predict the studied outcome. However, a single component of the MNA-SF score, specifically decreased mobility, was a significant risk factor for pneumonia (hazard ratio 2.289; 95% confidence interval 1.357-3.860; P = .002), independently of potential confounders.
The total MNA-SF score did not predict the incidence of pneumonia. However, decreased mobility was a significant risk factor, implying that individual components of the MNA-SF should be more carefully explored to verify whether they might be used for detecting specific declines of the health status in nursing home residents, thus potentially improving the risk profile estimation of such a complex population.
研究微型营养评定简表（MNA-SF）及其各个项目对肺炎发病率的预测价值。
为期1年随访的前瞻性观察队列研究。
来自养老院居民肺炎及相关后果发生率（INCUR）研究的13家法国养老院中的773名老年人（女性占74.4%）。
在基线时使用MNA-SF问卷评估营养状况。肺炎诊断基于从病历中获取的临床情况。应用Cox比例风险模型来测试MNA-SF评分及其单个组成部分是否能预测1年随访期内的肺炎事件。
随访1年后，记录到160例（21%）肺炎发病病例。参与者的平均年龄为86.2（标准差7.5）岁。MNA-SF平均评分为9.8（标准差2.4），超过一半的参与者（58.7%）存在营养不良风险（8 - 11分）。MNA-SF总分及其类别不能预测所研究的结果。然而，MNA-SF评分的一个单一组成部分，即活动能力下降，是肺炎的一个显著危险因素（风险比2.289；95%置信区间1.357 - 3.860；P = 0.002），独立于潜在混杂因素。
MNA-SF总分不能预测肺炎发病率。然而，活动能力下降是一个显著危险因素，这意味着应更仔细地探究MNA-SF的各个组成部分，以验证它们是否可用于检测养老院居民健康状况的特定下降，从而潜在地改善对此类复杂人群的风险评估。
