Department of Rehabilitation, Sapporo Nishimaruyama Hospital, Hokkaido, Japan.
Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Hyogo, Japan.
Geriatr Gerontol Int. 2017 Oct;17(10):1617-1622. doi: 10.1111/ggi.12942. Epub 2017 Feb 11.
The prevention of pneumonia is an urgent issue among Japanese older adults. However, little has been reported on the relationship between a Functional Independence Measure (FIM) and the Geriatric Nutrition Risk Index (GNRI) for the prevention of pneumonia in patients in long-term care facilities in Japan. We aimed to clarify the relevance of FIM and GNRI for inpatients with and without pneumonia.
We identified 233 patients who were hospitalized in our long-term nursing hospital from April 2012 to September 2013. We compared differences in FIM among GNRI classes for four groups: (i) pneumonia/high GNRI; (ii) pneumonia/low GNRI; (iii) no pneumonia/high GNRI; and (iv) no pneumonia/low GNRI. To assess the pneumonia predictors, we used a logistic regression for long-term nursing patients. Receiver operating characteristic analysis showed cut-off values and the area under the curve.
A total of 88 (37.8%) of 233 inpatients had pneumonia. FIM of the pneumonia/low GNRI groups was significantly lower than that of the no pneumonia/high and low GNRI groups. Logistic regression showed that FIM (P < 0.001; OR -1.035, 95% CI -1.019-1.051) and GNRI (P = 0.017; OR -1.038, 95% CI -1.007-1.070) were predictors of pneumonia. The cut-off values for FIM and GNRI were 26.6 (P < 0.001, the area under the curve 0.70) and 80.5 (P < 0.001, the area under the curve 0.65), respectively.
Low activity and malnutrition might lead to the development of pneumonia. FIM and GNRI are useful predictor tools that could help to prevent pneumonia in Japanese patients in long-term care facilities. Geriatr Gerontol Int 2017; 17: 1617-1622.
预防肺炎是日本老年人的一个紧迫问题。然而，关于功能独立性测量（FIM）与老年营养风险指数（GNRI）在日本长期护理机构患者预防肺炎中的关系，报道甚少。我们旨在阐明 FIM 和 GNRI 与伴有和不伴有肺炎的住院患者的相关性。
我们纳入了 2012 年 4 月至 2013 年 9 月在我院长期护理病房住院的 233 例患者。我们比较了 GNRI 四类人群的 FIM 差异：（i）肺炎/高 GNRI；（ii）肺炎/低 GNRI；（iii）无肺炎/高 GNRI；和（iv）无肺炎/低 GNRI。为了评估肺炎的预测因子，我们对长期护理患者进行了逻辑回归分析。受试者工作特征分析显示了截断值和曲线下面积。
共有 233 例住院患者中 88 例（37.8%）患有肺炎。肺炎/低 GNRI 组的 FIM 明显低于无肺炎/高和低 GNRI 组。逻辑回归显示 FIM（P<0.001；OR-1.035，95%CI-1.019-1.051）和 GNRI（P=0.017；OR-1.038，95%CI-1.007-1.070）是肺炎的预测因子。FIM 和 GNRI 的截断值分别为 26.6（P<0.001，曲线下面积 0.70）和 80.5（P<0.001，曲线下面积 0.65）。
活动减少和营养不良可能导致肺炎的发生。FIM 和 GNRI 是有用的预测工具，有助于预防日本长期护理机构患者的肺炎。
