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[在一家三级医院引入一种综合营养筛查工具(CIPA)]

[Introducing a mixed nutritional screening tool (CIPA) in a tertiary hospital].

作者信息

Suárez Llanos José Pablo, Benitez Brito Nestor, Oliva García José Gregorio, Pereyra-García Castro Francisca, López Frías María Alicia, García Hernández Alberto, Díaz Sirgo Belarmina, Llorente Gómez de Segura Ignacio

机构信息

Unidad de Nutrición y Dietética. Hospital Universitario Nuestra Señora de Candelaria. Santa Cruz de Tenerife. España..

Unidad de Medicina Interna. Hospital Universitario Nuestra Señora de Candelaria. Santa Cruz de Tenerife. España..

出版信息

Nutr Hosp. 2014 May 1;29(5):1149-53. doi: 10.3305/nh.2014.29.5.7299.

Abstract

INTRODUCTION

Malnourishment in hospitalized patients is very prevalent and therefore it is important to implement screening methods. A mixed nutritional screening method (CIPA) has been developed at our center; this method includes four parameters: (a) control of intakes for 72 h; (b) BMI; (c) proteins; and (d) albumin.

OBJECTIVES

(1) To know the prevalence of malnourishment at the Internal Medicine Department of our Center; (2) To analyze the variables associated to higher prevalence of malnourishment.

MATERIALS AND METHOD

The results of the nutritional screening tests carried out in 305 patients admitted to the Internal Medicine Department in the period of November of 2012-October of 2013 were retrospectively reviewed. The prevalence of hospital malnourishment was analyzed, as well as the association of a positive screening test (at least one positive item) with the following variables: BMI, age, gender, underlying disease, hospital staying, early re-admittance (< 1 month) and hospital mortality.

RESULTS

The test yielded a positive result in 23% of the patients. Patients with a positive screening test had lower BMI (24.9 ± 7.2 vs. 27.8 ± 6.4 kg/m; p = 0.002). Neoplastic and infectious pathologies were associated with greater positivity (35.3 and 28.9%, respectively; p = 0.006). Gender and age were not associated with a positive screening test. Patients with a positive screening test had longer mean hospital staying (26.7 ± 25 vs. 19.4 ± 16.5; p = 0.005), higher early re-admittance rates (18.6 vs. 6.8%; p = 0.003) and higher mortality (30 vs. 10.3%; p < 0.001).

CONCLUSIONS

The CIPA screening test can detect malnourished patients and predict worse clinical prognosis (mortality, mean hospital staying and early readmittance).

摘要

引言

住院患者营养不良的情况非常普遍,因此实施筛查方法很重要。我们中心开发了一种综合营养筛查方法(CIPA);该方法包括四个参数:(a)72小时摄入量控制;(b)体重指数(BMI);(c)蛋白质;以及(d)白蛋白。

目的

(1)了解我们中心内科营养不良的患病率;(2)分析与较高营养不良患病率相关的变量。

材料与方法

回顾性分析了2012年11月至2013年10月期间入住内科的305例患者的营养筛查测试结果。分析了医院营养不良的患病率,以及阳性筛查测试(至少一项阳性指标)与以下变量的关联:BMI、年龄、性别、基础疾病、住院时间、早期再入院(<1个月)和医院死亡率。

结果

该测试在23%的患者中得出阳性结果。筛查测试呈阳性的患者BMI较低(分别为24.9±7.2与27.8±6.4kg/m²;p=0.002)。肿瘤和感染性疾病与更高的阳性率相关(分别为35.3%和28.9%;p=0.006)。性别和年龄与阳性筛查测试无关。筛查测试呈阳性的患者平均住院时间更长(26.7±25与19.4±16.5天;p=0.005),早期再入院率更高(18.6%对6.8%;p=0.003),死亡率更高(30%对10.3%;p<0.001)。

结论

CIPA筛查测试可以检测出营养不良的患者,并预测更差的临床预后(死亡率、平均住院时间和早期再入院)。

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