Boban Marko, Laviano Alessandro, Persic Viktor, Rotim Ante, Jovanovic Zeljko, Vcev Aleksandar
a Department of Cardiology.
J Am Coll Nutr. 2014;33(6):466-73. doi: 10.1080/07315724.2013.876902. Epub 2014 Nov 11.
The aim of our study was to assess the prevalence and characteristics of nutritional risk in patients scheduled for cardiovascular rehabilitation.
Knowledge concerning nutritional aspects of cardiovascular diseases is contemporary limited.
Nutritional risk screening using a standardized Nutritional Risk Screening-2002 (NRS-2002) questionnaire was performed on a cohort of consecutive patients scheduled for rehabilitation 1-6 months after treatment for ischemic, valvular, or combined causes of heart diseases. Baseline weight was available for more than 80% of patients.
The study population consisted of 317 patients, aged 23-85 years, with a mean age of 62.5 ± 11.3 years. Male to female share was 253 (79.8%) and 64 (20.2%), respectively. Twenty-eight (8.8%) were treated for myocardial infarction conservatively, 151 (47.6%) by percutaneous coronary interventions, and 145 (45.7%) by surgery. NRS-2002 was 3.56 ± 1.54 in range 0-6. A high correlation was found between the NRS-2002 and percentage weight loss history (rho = 0.813; p <0.001). Significant differences according to increased nutritional risk (NRS-2002 ≥ 3) were found within age groups (p < 0.001), disease etiology (p = 0.002), cardiovascular treatments (p < 0.001), and grades of renal function (p < 0.001). Odds for developing increased nutritional risk (NRS-2002 ≥ 3) were significant for cardiovascular treatments (odds ratio [OR] = 4.35, 95% confidence interval [CI], 2.28-8.30, p < 0.001), age (OR = 3.19, 95% CI, 2.00-5.09, p < 0.001), grade of renal function (OR = 1.91, 95% CI, 1.17-3.09, p = 0.009), diabetes mellitus (OR = 2.37, 95% CI, 1.09-5.16, p = 0.029), and any psychological disturbance (OR = 2.04, 95% CI, 1.06-3.90, p = 0.032).
Pronounced nutritional risk frequently existed among patients at stationary cardiovascular rehabilitation. Nutritional risk was connected with preceding cardiovascular treatments, patient age, and renal function. Further studies concerning nutritional risk and its connections with clinical outcomes might serve as a resourceful perspective to improve outcomes or quality of care for the entities from the cardiovascular diseases continuum.
本研究旨在评估计划进行心血管康复治疗的患者中营养风险的患病率及特征。
关于心血管疾病营养方面的知识目前有限。
对一组连续的患者进行营养风险筛查,这些患者在因缺血性、瓣膜性或合并性心脏病接受治疗后1至6个月计划进行康复治疗,使用标准化的2002年营养风险筛查(NRS - 2002)问卷。超过80%的患者有基线体重数据。
研究人群包括317例患者,年龄在23至85岁之间,平均年龄为62.5±11.3岁。男女比例分别为253例(79.8%)和64例(20.2%)。28例(8.8%)接受心肌梗死保守治疗,151例(47.6%)接受经皮冠状动脉介入治疗,145例(45.7%)接受手术治疗。NRS - 2002范围为0至6,均值为3.56±1.54。发现NRS - 2002与体重减轻史百分比之间存在高度相关性(rho = 0.813;p <0.001)。在年龄组(p <0.001)、疾病病因(p = 0.002)、心血管治疗方式(p <0.001)和肾功能分级(p <0.001)方面,根据营养风险增加(NRS - 2002≥3)存在显著差异。发生营养风险增加(NRS - 2002≥3)的几率在心血管治疗方式(优势比[OR]=4.35,95%置信区间[CI],2.28 - 8.30,p <0.001)、年龄(OR = 3.19,95% CI,2.00 - 5.09,p <0.001)、肾功能分级(OR = 1.91,95% CI,1.17 - 3.09,p = 0.009)、糖尿病(OR = 2.37,95% CI,1.09 - 5.16,p = 0.029)和任何心理障碍(OR = 2.04,95% CI,1.06 - 3.90,p = 0.032)方面具有显著性。
在心血管康复住院患者中经常存在明显的营养风险。营养风险与先前的心血管治疗、患者年龄和肾功能有关。关于营养风险及其与临床结局关系的进一步研究可能为改善心血管疾病连续体中各实体的结局或护理质量提供有益的视角。