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挪威急性老年患者中与营养不良相关因素的患病率:一项横断面研究。

Prevalence of factors associated with malnutrition among acute geriatric patients in Norway: a cross-sectional study.

作者信息

Jacobsen Ellisiv Lærum, Brovold Therese, Bergland Astrid, Bye Asta

机构信息

Faculty of Health Sciences, Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.

Department of Oncology, Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Oslo, Norway Faculty of Health Sciences, Department of Nursing and Health promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.

出版信息

BMJ Open. 2016 Sep 6;6(9):e011512. doi: 10.1136/bmjopen-2016-011512.

Abstract

OBJECTIVES

Data on acute geriatric patients' nutritional status are lacking, and the associations among physical function, sarcopenia, health status and nutritional status are not sufficiently investigated in this population. The aims of this study are to investigate (1) nutritional status and sarcopenia in a group of acute geriatric patients, (2) the association between nutritional status, physical function and sarcopenia in acute geriatric patients, controlling for health status.

DESIGN

A cross-sectional study.

SETTING

Two acute geriatric hospital wards in Norway.

PARTICIPANTS

This study included 120 patients with a mean age of 82.6±8 years. The following inclusion criteria were used: age ≥65 years and admitted to an acute geriatric ward. The exclusion criteria included terminal illness, Mini-Mental State Examination <23, language difficulties or severe aphasia.

MAIN OUTCOME MEASURES

Nutritional status was assessed using the Mini Nutritional Assessment (MNA). Physical function was measured using the Barthel activities of daily life index and the Short Physical Performance Battery (SPPB). Sarcopenia was diagnosed using the mid-arm muscle circumference, gait speed and grip strength, in accordance with the EWGSOP algorithm. Diseases are organised by organ system classification.

RESULTS

On the basis of the MNA classification, nearly one in two patients were at risk of malnutrition, while one in four were malnourished. Sarcopenia was present in 30% of the patients. A multivariate linear regression model was estimated and showed significant independent associations between SPPB score (β 0.64, 95% CI 0.38 to 0.90), sarcopenia (β -3.3, 95% CI -4.9 to -1.7), pulmonary disease (β -2.1, 95% CI -3.7 to -0.46), cancer (β -1.7, 95% CI -3.4 to -0.033) and nutritional status.

CONCLUSIONS

Our study shows a high prevalence of risk of malnutrition, malnutrition and sarcopenia. Further, the results indicate that a low total SPPB score, sarcopenia, cancer and pulmonary disease are significantly associated with declines in nutritional status, as measured by the MNA, in acute geriatric patients.

摘要

目的

缺乏关于急性老年患者营养状况的数据,且该人群中身体功能、肌肉减少症、健康状况与营养状况之间的关联尚未得到充分研究。本研究的目的是调查:(1)一组急性老年患者的营养状况和肌肉减少症;(2)在控制健康状况的情况下,急性老年患者营养状况、身体功能与肌肉减少症之间的关联。

设计

横断面研究。

地点

挪威的两个急性老年病医院病房。

参与者

本研究纳入了120名平均年龄为82.6±8岁的患者。采用以下纳入标准:年龄≥65岁且入住急性老年病病房。排除标准包括终末期疾病、简易精神状态检查表评分<23、语言障碍或严重失语。

主要观察指标

使用微型营养评定法(MNA)评估营养状况。使用巴氏日常生活活动指数和简短体能状况量表(SPPB)测量身体功能。根据欧洲老年人肌肉减少症工作组(EWGSOP)算法,使用上臂中部肌肉周长、步速和握力诊断肌肉减少症。疾病按器官系统分类。

结果

根据MNA分类,近二分之一的患者存在营养不良风险,四分之一的患者营养不良。30%的患者存在肌肉减少症。估计了一个多元线性回归模型,结果显示SPPB评分(β 0.64,95%可信区间0.38至0.90)、肌肉减少症(β -3.3,95%可信区间-4.9至-1.7)、肺部疾病(β -2.1,95%可信区间-3.7至-0.46)、癌症(β -1.7,95%可信区间-3.4至-0.033)与营养状况之间存在显著的独立关联。

结论

我们的研究表明,营养不良风险、营养不良和肌肉减少症的患病率很高。此外,结果表明,急性老年患者中,总SPPB评分低、肌肉减少症、癌症和肺部疾病与MNA测量的营养状况下降显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e00/5020767/414ed1b1f52d/bmjopen2016011512f01.jpg

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