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住院吞咽困难患者营养不良的患病率及成本:PREDYCES研究的亚分析

PREVALENCE AND COSTS OF MALNUTRITION IN HOSPITALIZED DYSPHAGIC PATIENTS: A SUBANALYSIS OF THE PREDYCES STUDY.

作者信息

Álvarez Hernández Julia, León Sanz Miguel, Planas Vilá Mercè, Araujo Krysmarú, García de Lorenzo Abelardo, Celaya Pérez Sebastián

机构信息

Hospital Universitario Príncipe de Asturias, Madrid..

Clinical Nutrition Unit, Hospital Universitario 12 de Octubre..

出版信息

Nutr Hosp. 2015 Oct 1;32(4):1830-6. doi: 10.3305/nh.2015.32.4.9700.

Abstract

INTRODUCTION

dysphagia and malnutrition are conditions that frequently appear together in hospitalized patients.

OBJECTIVES

the main purpose of this study was to analyze the prevalence of malnutrition in patients with dysphagia included in the PREDyCES study as well as to determine its clinical and economic consequences.

METHODS

this is a substudy of an observational, cross-sectional study conducted in 31 sites all over Spain.

RESULTS

352 dysphagic patients were included. 45.7% of patients presented with malnutrition (NRS-2002 ≥ 3) at admission and 42.2% at discharge. In elderly patients (≥ 70 years old) prevalence of malnutrition was even higher: 54.6% at admission and 57.5% at discharge. Also, prevalence of malnutrition was higher in urgent admissions versus those scheduled (45.7% vs 33.3%; p < 0.05) and when admitted to small hospitals vs. large hospitals (62.8% vs 43.9%; p < 0.001). In-hospital length of stay was higher in malnourished patients compared to those well-nourished (11.5 ± 7.1 days vs. 8.8 ± 6.05 days; p < 0.001), and in malnourished patients a tendency towards increase related-costs was also observed, even though it was not statistically significant (8 004 ± 5 854 € vs. 6 967 ± 5 630 €; p = 0.11). Length of stay was also higher in elderly patients (≥ 70 y/o) vs adults (< 70 y/o). 25% of dysphagic patients and 34.6% of malnourished patients with dysphagia received nutritional support during hospitalization.

DISCUSSION

these results confirm that in patients with dysphagia, malnutrition is a prevalent and under recognized condition, that also relates to prolonged hospitalizations.

摘要

引言

吞咽困难和营养不良在住院患者中经常同时出现。

目的

本研究的主要目的是分析纳入PREDyCES研究的吞咽困难患者中营养不良的患病率,并确定其临床和经济后果。

方法

这是一项在西班牙各地31个地点进行的观察性横断面研究的子研究。

结果

纳入了352例吞咽困难患者。45.7%的患者入院时存在营养不良(NRS-2002≥3),出院时为42.2%。老年患者(≥70岁)营养不良的患病率更高:入院时为54.6%,出院时为57.5%。此外,急诊入院患者的营养不良患病率高于择期入院患者(45.7%对33.3%;p<0.05),入住小医院的患者高于大医院(62.8%对43.9%;p<0.001)。营养不良患者的住院时间长于营养良好的患者(11.5±7.1天对8.8±6.05天;p<0.001),并且在营养不良患者中也观察到相关费用增加的趋势,尽管没有统计学意义(8004±5854€对6967±5630€;p=0.11)。老年患者(≥70岁)的住院时间也长于成年人(<70岁)。25%的吞咽困难患者和34.6%的吞咽困难营养不良患者在住院期间接受了营养支持。

讨论

这些结果证实,在吞咽困难患者中,营养不良是一种普遍存在但未得到充分认识的情况,并且与住院时间延长有关。

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