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老年糖尿病患者住院期间新的ESPEN营养不良定义的应用:一项多中心研究。

Application of the new ESPEN definition of malnutrition in geriatric diabetic patients during hospitalization: A multicentric study.

作者信息

Sanz-París Alejandro, Gómez-Candela Carmen, Martín-Palmero Ángela, García-Almeida José M, Burgos-Pelaez Rosa, Matía-Martin Pilar, Arbones-Mainar Jose M

机构信息

Nutrition Department of University Hospital Miguel Servet, Zaragoza, Spain.

Nutrition Department of University Hospital La Paz, Madrid, Spain.

出版信息

Clin Nutr. 2016 Dec;35(6):1564-1567. doi: 10.1016/j.clnu.2016.02.018. Epub 2016 Mar 8.

Abstract

BACKGROUND & AIMS: The European Society for Clinical Nutrition and Metabolism (ESPEN) recently provided new diagnosis criteria of malnutrition and called to confirm those criteria in specific populations. The aims of our study were 1) to determine the prevalence of malnutrition according to the new ESPEN definition in elder hospitalized diabetic patients, and 2) to evaluate whether this new diagnosis of malnutrition predicted clinical outcomes in these patients.

METHODS

1014 hospitalized diabetic patients (≥65 years) from 35 hospitals in Spain were screened for being at risk of malnutrition using the short version of the Mini Nutritional Assessment. Subsequently, at risk individuals were considered malnourished if they met at least one of the two options: 1) body mass index (BMI) < 18.5 kg/m, or 2) unintentional weight loss >5% of their body weight with reduced BMI (<20 kg/m in subjects younger than 70 years or <22 kg/m in subjects older than 70 years).

RESULTS

The new ESPEN definition, with MNA-SF as initial screening, identified 68 malnourished geriatric individuals with diabetes (6.73% of the cohort). Additionally, malnutrition lengthened the hospital stay, increased 2.7 times the odds of dying in hospital, and decreased to one third the odds of being discharged home.

CONCLUSIONS

Our study confirms that the new ESPEN definition for the diagnosis of malnutrition is a reliable tool that is capable of predicting clinical outcomes in a large population of elder hospitalized individuals with diabetes.

摘要

背景与目的

欧洲临床营养与代谢学会(ESPEN)近期提供了营养不良的新诊断标准,并呼吁在特定人群中对这些标准进行验证。我们研究的目的是:1)根据ESPEN的新定义确定老年住院糖尿病患者中营养不良的患病率;2)评估这种新的营养不良诊断是否能预测这些患者的临床结局。

方法

使用简易营养评估简表,对西班牙35家医院的1014名住院糖尿病患者(≥65岁)进行营养不良风险筛查。随后,如果高危个体符合以下两种情况中的至少一种,则被视为营养不良:1)体重指数(BMI)<18.5kg/m²;2)非故意体重减轻超过其体重的5%,且BMI降低(70岁以下患者<20kg/m²,70岁以上患者<22kg/m²)。

结果

以MNA-SF作为初始筛查的ESPEN新定义,识别出68名营养不良的老年糖尿病患者(占队列的6.73%)。此外,营养不良会延长住院时间,使院内死亡几率增加2.7倍,并使出院回家的几率降至三分之一。

结论

我们的研究证实,ESPEN用于诊断营养不良的新定义是一种可靠的工具,能够预测大量老年住院糖尿病患者的临床结局。

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