急诊科老年患者营养不良的危险因素：一项多中心研究
Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.
作者信息
Burks Collin E, Jones Christopher W, Braz Valerie A, Swor Robert A, Richmond Natalie L, Hwang Kay S, Hollowell Allison G, Weaver Mark A, Platts-Mills Timothy F
机构信息
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Emergency Medicine, Cooper University Hospital, Camden, New Jersey.
出版信息
J Am Geriatr Soc. 2017 Aug;65(8):1741-1747. doi: 10.1111/jgs.14862. Epub 2017 Mar 21.
BACKGROUND
Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury.
OBJECTIVE
To identify modifiable risk factors associated with malnutrition in older patients.
DESIGN
Prospective cross-sectional multicenter study.
SETTING
3 EDs in the South, Northeast, and Midwest.
PARTICIPANTS
Non-critically ill, English-speaking adults aged ≥65 years.
MEASUREMENTS
Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor.
RESULTS
In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%).
CONCLUSION
Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults.
背景
在老年人中，营养不良很常见，常常被医疗服务提供者忽视，并且会影响疾病或损伤后的康复。
目的
确定老年患者中与营养不良相关的可改变风险因素。
设计
前瞻性横断面多中心研究。
地点
南部、东北部和中西部的3家急诊科。
参与者
年龄≥65岁、非危重症、讲英语的成年人。
测量
采用随机时间块抽样法招募患者。急诊科访谈使用简易营养评估简表评估营养不良情况。使用经过验证的方法评估粮食不安全和口腔健康状况不佳。检查的其他风险因素包括抑郁症状、行动不便、缺乏交通工具、孤独感和药物副作用，并根据患者是否报告该风险因素影响其饮食进行限定。估计每个风险因素导致营养不良的人群归因风险比例（PARP）。
结果
在我们的样本（n = 252）中，营养不良的患病率为12%。与营养不良相关的患者特征包括没有大学学历、住院以及居住在辅助生活设施中。在检查的风险因素中，口腔健康状况不佳导致营养不良的PARP最高（54%；95%CI 16%，78%），粮食不安全（14%；95%CI 3%，31%），以及缺乏交通工具影响饮食（12%；95%CI 3%，28%）。
结论
这项观察性研究的结果确定了与老年人营养不良问题相关的多个可改变因素。
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