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评估CONUT在老年住院患者临床营养不良检测及短期预后评估中的应用

Evaluation of CONUT for Clinical Malnutrition Detection and Short-Term Prognostic Assessment in Hospitalized Elderly People.

作者信息

Cabré M, Ferreiro C, Arus M, Roca M, Palomera E, Serra-Prat M

机构信息

M. Serra-Prat, Consorci Sanitari del Maresme, Research unit, Carretera de cIRERA S/N, Mataró, Barcelona 08304, Spain,

出版信息

J Nutr Health Aging. 2015 Aug;19(7):729-33. doi: 10.1007/s12603-015-0536-6.

Abstract

OBJECTIVES

To assess agreement between the CONUT and Mini Nutritional Assessment (MNA) instruments in detecting malnutrition in hospitalized elderly patients and to determine their prognostic value compared to that of serum albumin alone in relation to in-hospital and 1-month and 6-month post-discharge mortality rates.

DESIGN

Prospective observational study.

SETTING

A Catalan regional hospital.

PARTICIPANTS

2155 patients admitted to an acute geriatric unit were assessed using MNA and CONUT and were followed up for 6 months after discharge.

MEASUREMENTS

On admission, data were collected on age, sex, referral, geriatric syndromes, cognitive status, functional status and nutritional status according to MNA (as the gold standard). Plasma albumin, total cholesterol and lymphocyte levels were recorded to implement CONUT. Mortality was recorded until 6 months after discharge.

RESULTS

Sample characteristics: 61.3% females, mean age 84.9 years, mean Charlson index 2.2. CONUT sensitivity and specificity for malnutrition were 43% and 71.6%, respectively, with positive and negative predictive values of 88.9% and 19.2%. MNA, CONUT and albumin alone were good predictors of mortality but showed similar sensitivity and specificity results.

CONCLUSION

CONUT agreement with MNA in nutritional risk assessments for elderly people is poor. Although CONUT is a good predictor of short-and medium-term mortality, it adds little to information provided by albumin alone.

摘要

目的

评估控制营养风险(CONUT)与微型营养评定法(MNA)在检测老年住院患者营养不良方面的一致性,并确定与单独血清白蛋白相比,它们在预测住院期间、出院后1个月和6个月死亡率方面的预后价值。

设计

前瞻性观察性研究。

地点

加泰罗尼亚地区医院。

参与者

对入住急性老年病科的2155名患者使用MNA和CONUT进行评估,并在出院后随访6个月。

测量

入院时,收集年龄、性别、转诊情况、老年综合征、认知状态、功能状态和根据MNA(作为金标准)评估的营养状态等数据。记录血浆白蛋白、总胆固醇和淋巴细胞水平以实施CONUT。记录出院后6个月内的死亡率。

结果

样本特征:女性占61.3%,平均年龄84.9岁,平均查尔森指数为2.2。CONUT对营养不良的敏感性和特异性分别为43%和71.6%,阳性预测值和阴性预测值分别为88.9%和19.2%。单独的MNA、CONUT和白蛋白都是死亡率的良好预测指标,但敏感性和特异性结果相似。

结论

CONUT在老年人营养风险评估中与MNA的一致性较差。虽然CONUT是短期和中期死亡率的良好预测指标,但它对单独白蛋白提供的信息增加不多。

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