Cano-Torres Edgar A, Simental-Mendía Luis E, Morales-Garza Luis A, Ramos-Delgado José M, Reyes-Gonzalez Mirthala M, Sánchez-Nava Victor M, Barragán-Berlanga Abel de J, Rangel-Rodríguez Ignacio, Guerrero-Romero Fernando
a Hospital San José, Escuela Nacional de Medicina del Tecnológico de Monterrey , Monterrey , Nuevo León , México.
b Biomedical Research Unit of the Mexican Social Security Institute at Durango , Durango , Dgo ., México.
J Am Coll Nutr. 2017 May-Jun;36(4):235-239. doi: 10.1080/07315724.2016.1259595. Epub 2017 Mar 20.
The objective of this study was to evaluate the impact of a nutritional intervention on hospital stay and mortality among hospitalized patients with malnutrition.
Hospitalized patients with a diagnosis of malnutrition were enrolled and randomly allocated to either an intervention or control group. Participants in the intervention group received an individualized nutrition plan according to energy and protein (1.0-1.5 g/kg) intake requirements as well as dietary advice based on face-to-face interviews with patients and their caregivers or family members. Individuals in the control group received standard nutritional management according to the Hospital Nutrition Department. Nutritional status and disease severity were assessed using nutritional risk screening. Length of hospital stay was defined by the number of days of hospitalization from hospital admission to medical discharge. Reference to another service or death were criteria for study withdrawal. To evaluate mortality, individuals were followed up for 6 months after hospital discharge. Hospital stay and mortality were the intention-to-treat analysis.
A total of 55 patients with an average age of 57.1 ± 20.7 years were included into intervention (n = 28) and control (n = 27) groups, respectively. At basal condition, nutritional status, measured by nutritional risk screening score, was similar between the study groups (4.1 ± 0.8 vs 4.2 ± 1.2, p = 0.6). The average hospital stay was lower in the intervention group compared to the control group (6.4 ± 3.0 vs 8.4 ± 4.0 days, p = 0.03). Finally, the mortality rate at 6 months of follow-up was similar in both groups (hazard ratio [HR] = 0.85; 95% confidence interval [CI], 0.17-4.21).
Results of this study suggest that, in hospitalized patients with malnutrition, nutritional intervention and dietary advice decrease hospital stay but not mortality.
本研究的目的是评估营养干预对营养不良住院患者住院时间和死亡率的影响。
纳入诊断为营养不良的住院患者，并随机分为干预组或对照组。干预组参与者根据能量和蛋白质（1.0 - 1.5 g/kg）摄入需求接受个性化营养计划，以及基于与患者及其护理人员或家庭成员面对面访谈的饮食建议。对照组个体接受医院营养科的标准营养管理。使用营养风险筛查评估营养状况和疾病严重程度。住院时间由从入院到出院的住院天数定义。转至其他科室或死亡是研究退出的标准。为评估死亡率，患者出院后随访6个月。住院时间和死亡率采用意向性分析。
共55例平均年龄为57.1±20.7岁的患者分别纳入干预组（n = 28）和对照组（n = 27）。在基础状态下，通过营养风险筛查评分测量的营养状况在研究组之间相似（4.1±0.8 vs 4.2±1.2，p = 0.6）。干预组的平均住院时间低于对照组（6.4±3.0 vs 8.4±4.0天，p = 0.03）。最后，两组在随访6个月时的死亡率相似（风险比[HR]=0.85；95%置信区间[CI]，0.17 - 4.21）。
本研究结果表明，在营养不良的住院患者中，营养干预和饮食建议可缩短住院时间，但不能降低死亡率。
