Keller H, Laporte M, Payette H, Allard J, Bernier P, Duerksen D, Gramlich L, Jeejeebhoy K
Department of Kinesiology, Schlegel-University of Waterloo Research Institute for Aging, Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Réseau de santé Vitalité Health Network, Campbellton Regional Hospital, Campbellton, New Brunswick, Canada.
Eur J Clin Nutr. 2017 Jun;71(6):766-772. doi: 10.1038/ejcn.2016.277. Epub 2017 Feb 22.
BACKGROUND/OBJECTIVES: Little is known about factors associated with weight change post discharge from hospital; yet poor nutritional status in the transition from hospital to community can result in readmission. This exploratory study aimed to determine the factors associated with weight change 30 days post discharge defined as weight gain (WG; 5+ pounds), weight loss (WL; 5+pounds) or weight stable (WS).
SUBJECTS/METHODS: A total of 922 medical or surgical patients were recruited from 16 acute care hospitals in 8 Canadian provinces. Telephone interviews were completed with 747 (81%) participants 30 days post discharge using a standardized questionnaire that included: self-reported weight change, assessment of appetite, usage of healthcare services and supports for food-related activities of daily living. Covariates collected during hospitalization, including nutritional status at discharge evaluated by subjective global assessment (SGA), were used in logistic regressions.
Among the 747 patients, 26% reported WL, 16.7% had WG and 57.2% were WS. Those with WG were: younger (odds ratio (OR) 0.77 (0.69, 0.85)), male (OR 1.71 (1.12, 2.61)), malnourished at discharge (SGA B OR 2.13 (1.36, 3.33), SGA C OR 2.76 (1.19, 6.62)), and had a good appetite based on the low OR for fair/poor appetite (OR 0.28 (0.11, 0.66)). WL was associated with being on a special diet (OR 1.45 (1.07,1.96)) and reporting fair/poor appetite (OR 2.67 (1.76, 4.07)).
Weight change was relatively common with WL predominating. Several variables were identified to be predictors of WL or weight gain, with appetite being common to both. Future work to further define and confirm these associations is warranted.
背景/目的:关于出院后体重变化相关因素的了解甚少;然而,从医院过渡到社区期间的营养不良状况可能导致再次入院。这项探索性研究旨在确定出院30天后体重变化的相关因素,体重变化定义为体重增加(WG;增加5磅及以上)、体重减轻(WL;减轻5磅及以上)或体重稳定(WS)。
受试者/方法:从加拿大8个省份的16家急症医院招募了922名内科或外科患者。出院30天后,对747名(81%)参与者进行了电话访谈,使用标准化问卷,内容包括:自我报告的体重变化、食欲评估、医疗服务使用情况以及对与食物相关的日常生活活动的支持。住院期间收集的协变量,包括通过主观全面评定法(SGA)评估的出院时营养状况,用于逻辑回归分析。
在747名患者中,26%报告体重减轻,16.7%体重增加,57.2%体重稳定。体重增加者的特征为:年龄较小(优势比(OR)0.77(0.69,0.85))、男性(OR 1.71(1.12,2.61))、出院时营养不良(SGA B级OR 2.13(1.36,3.33),SGA C级OR 2.76(1.19,6.62)),并且基于食欲一般/较差的低OR值表明食欲良好(OR 0.28(0.11,0.66))。体重减轻与特殊饮食(OR 1.45(1.07,1.96))以及食欲一般/较差(OR 2.67(1.76,4.07))相关。
体重变化较为常见,以体重减轻为主。确定了几个变量为体重减轻或体重增加的预测因素,食欲是两者的共同因素。有必要开展进一步工作以进一步明确和证实这些关联。