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长期护理机构中通过定期提供非治疗性膳食的能量摄入:对营养状况及相关老年营养风险指数的影响

The energy intake through regular nontherapeutic meals provision in long-term care: impact on nutritional status and related Geriatric Nutritional Risk Index.

作者信息

Sturtzel Baerbel, Elmadfa Ibrahim, Ohrenberger Gerald

机构信息

Department of Nutritional Sciences, University of Vienna, Althanstraße 14, 1090 Vienna, Austria.

"Haus der Barmherzigkeit", Long Term Care Hospital, Seeböckgasse 30a, 1160 Vienna, Austria.

出版信息

Springerplus. 2016 Feb 20;5:136. doi: 10.1186/s40064-016-1763-y. eCollection 2016.

DOI:10.1186/s40064-016-1763-y
PMID:26933634
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4761357/
Abstract

To investigate how the energy intake of institutionalized long-term-care patients through the regular nontherapeutic meals provision is associated with the nutritional status and the Geriatric Nutritional Risk Index (GNRI). A 9 month longitudinal, observational study. Long-term-care Hospital. 66 long-term-care patients with multiple medical conditions and solely oral food-intake. 47 (71 %) patients, predominantly women (n = 39/47), with a mean age of 83.04 (±9.58) years completed study time and 19 (29 %) deceased. At week 1 and week 36 of observation time energy intake was measured by means of three-days-weighing-records. Body composition was assessed with bioelectrical impedance analysis. Serum albumin, body weight and body height were taken from the medical report. Albumin content, body weight and height were used to calculate the Geriatric Nutritional Risk Index: GNRI = [1.489 × albumin (g/L)] + [41.7 × (weight/ideal body weight)]. Energy intake was significantly below 24 kcal/kg body weight per day. The GNRI of the deceased patients was significantly (p = 0.002) lower than the GNRI of the completers. During observation time energy-intake p < 0.001, body fat (p = 0.001) and phase angle (PA) of bio impedance measurement (p = 0.018) and likewise the GNRI (p = 0.021) of the completers decreased significantly. At the beginning and at the end of observation time energy intake correlated significantly with PA (p = 0.028/p < 0.001) and GNRI (p = 0.436/p = 0.004). Also GNRI and PA correlated significantly at the beginning (p = 0.001) and at the end (p < 0.001) of observation time. The energy intake through non therapeutic meals provision was too low for sustaining the nutritional status and likewise the GNRI. The malnourishment and the nutrition related clinical risk of the geriatric patients aggrevated during observation time.

摘要

调查通过定期提供非治疗性膳食,机构化长期护理患者的能量摄入与营养状况及老年营养风险指数(GNRI)之间的关系。一项为期9个月的纵向观察性研究。长期护理医院。66例患有多种疾病且仅通过口服摄入食物的长期护理患者。47例(71%)患者完成了研究期,其中女性居多(n = 39/47),平均年龄为83.04(±9.58)岁,19例(29%)患者死亡。在观察期的第1周和第36周,通过3天称重记录来测量能量摄入。采用生物电阻抗分析评估身体成分。血清白蛋白、体重和身高数据来自医疗报告。白蛋白含量、体重和身高用于计算老年营养风险指数:GNRI = [1.489×白蛋白(g/L)]+[41.7×(体重/理想体重)]。能量摄入显著低于每天24千卡/千克体重。死亡患者的GNRI显著低于完成研究的患者(p = 0.002)。在观察期内,完成研究的患者的能量摄入(p < 0.001)、体脂(p = 0.001)和生物电阻抗测量的相位角(PA)(p = 0.018)以及GNRI(p = 0.021)均显著下降。在观察期开始和结束时,能量摄入与PA(p = 0.028/p < 0.001)和GNRI(p = 0.436/p = 0.004)均显著相关。在观察期开始时(p = 0.001)和结束时(p < 0.001),GNRI和PA也显著相关。通过提供非治疗性膳食的能量摄入过低,无法维持营养状况及GNRI。在观察期内,老年患者的营养不良及与营养相关的临床风险加剧。