根据多重对应分析，有或无肿瘤患者的营养状况与临床结局之间的关系

RELATIONSHIP BETWEEN NUTRITIONAL STATUS AND THE CLINICAL OUTCOMES OF PATIENTS WITH AND WITHOUT NEOPLASMS ACCORDING TO MULTIPLE CORRESPONDENCE ANALYSIS.

作者信息

Leandro-Merhi Vânia Aparecida, Aquino José Luiz Braga de

机构信息

Faculdade de Nutrição, Pontifícia Universidade Católica de Campinas-Campinas, SP, Brazil.

Faculdade de Medicina, Pontifícia Universidade Católica de Campinas-Campinas, SP, Brazil.

出版信息

Arq Gastroenterol. 2017 Apr-Jun;54(2):148-155. doi: 10.1590/S0004-2803.201700000-05. Epub 2017 Mar 16.

DOI:10.1590/S0004-2803.201700000-05

PMID:28198916

Abstract

BACKGROUND

For many years, many studies have reported undesirable outcomes that may occur during the hospital stay of patients diagnosed with malnutrition or even at some nutritional risk.

OBJECTIVE

To investigate the relationship between nutritional status and clinical outcomes during hospital stay using the multiple correspondence analysis technique.

METHODS

This cross-sectional study included 600 patients with and without neoplasms. The following data were collected: subjective global assessment, nutritional indicators, nutritional risk screening, anthropometric data (body mass index (BMI), mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MUAMC), triceps skinfold thickness (TST), recent weight loss (RWL)), and habitual energy intake (HEI/ER <75%). The clinical outcomes of interest were complications, length of hospital stay (LOHS), and death. The data were analyzed by the chi-square or Fisher's exact test at a significance level of 5%. Multiple correspondence analysis was used for the multivariate data analysis.

RESULTS

The multiple correspondence analysis map for the patients with neoplasms showed that the following characteristics were associated and represented by death, complications, and a greater likelihood of LOHS ≥7 days: underweight according to BMI; TST, MUAC, and MUAMC ≤15th percentile; malnutrition according to the subjective global assessment; at nutritional risk according to the nutritional risk screening; being male; age ≥60 years; and HEI/ER <75%. The multiple correspondence analysis map for the patients without neoplasms showed that the following characteristics were associated and represented by death: underweight according to BMI; TST ≤15th percentile; malnutrition according to the subjective global assessment; and at nutritional risk according to the nutritional risk screening. Complications and LOHS ≥7 days represented the categories male, no recent weight loss, HEI/ER <75%, MUAC and MUAMC ≤15th percentile, TST between the 15th and 85th percentiles, and age <60 years.

CONCLUSION

The results of this study confirm an association between unsatisfactory nutritional indicators and undesirable clinical outcomes.

摘要

背景

多年来，许多研究报告了被诊断为营养不良甚至存在一定营养风险的患者在住院期间可能出现的不良后果。

目的

使用多重对应分析技术研究住院期间营养状况与临床结局之间的关系。

方法

这项横断面研究纳入了600例有或无肿瘤的患者。收集了以下数据：主观全面评定、营养指标、营养风险筛查、人体测量数据（体重指数（BMI）、上臂中部周长（MUAC）、上臂中部肌肉周长（MUAMC）、三头肌皮褶厚度（TST）、近期体重减轻（RWL））以及习惯性能量摄入（HEI/ER<75%）。感兴趣的临床结局为并发症、住院时间（LOHS）和死亡。数据采用卡方检验或Fisher精确检验进行分析，显著性水平为5%。多重对应分析用于多变量数据分析。

结果

肿瘤患者的多重对应分析图显示，以下特征与死亡、并发症以及住院时间≥7天的可能性增加相关并表现为：根据BMI定义的体重过低；TST、MUAC和MUAMC≤第15百分位数；根据主观全面评定的营养不良；根据营养风险筛查存在营养风险；男性；年龄≥60岁；以及HEI/ER<75%。非肿瘤患者的多重对应分析图显示，以下特征与死亡相关并表现为：根据BMI定义的体重过低；TST≤第15百分位数；根据主观全面评定的营养不良；以及根据营养风险筛查存在营养风险。并发症和住院时间≥7天表现为以下类别：男性、无近期体重减轻、HEI/ER<75%、MUAC和MUAMC≤第15百分位数、TST在第15至85百分位数之间以及年龄<60岁。