Müller F S, Meyer O W, Chocano-Bedoya P, Schietzel S, Gagesch M, Freystaetter G, Neuhaus V, Simmen H-P, Langhans W, Bischoff-Ferrari H A
Department of Geriatrics and Aging Research, University Hospital Zurich, Zurich, Switzerland.
Centre on Aging and Mobility, University Hospital Zurich, Zurich, Switzerland.
Eur J Clin Nutr. 2017 May;71(5):602-606. doi: 10.1038/ejcn.2017.25. Epub 2017 Mar 22.
BACKGROUND/OBJECTIVES: Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients.
SUBJECTS/METHODS: We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score<17=malnourished (M), ⩽23.5=at risk of malnutrition (ARM), >23.5=normal). At the same examination, we assessed mental (Geriatric Depression Scale; GDS) and cognitive function (Mini-Mental State Examination; MMSE), frailty status (Fried Scale), and number of comorbidities and medications. Further, discharge destination was documented. All analyses were adjusted for age and gender.
A total of 7.1% of patients were malnourished and 49.1% were ARM. Patients with reduced mental health (GDS⩾5: 30.5 vs 11.5%; P=0.004), impaired cognitive function (MMSE⩽26: 23.6±0.5 vs 26.0±0.6; P=0.004), prevalent frailty (32.5 vs 8%; P<0.001), more comorbidities (2.3±0.1 vs 1.3±0.2; P<0.0001) and medications (5.6±0.3 vs 3.4±0.4; P<0.0001) were more likely to have an impaired nutritional status (M+ARM). Further, M+ARM patients were twice as likely to be discharged to destinations different to home (odds ratio=2.08; confidence interval 1.07-4.05).
In this consecutive sample of geriatric trauma patients, 56.2% had an M+ARM upon admission to acute care, which was associated with indicators of worse physical, mental and cognitive health and predicted a more than twofold greater odds of being discharged to a destination other than home.
背景/目的：营养不良是不良临床结局的既定风险因素。我们的目的是评估老年创伤患者的营养状况。
受试者/方法：我们纳入了169例连续入住老年创伤中心（瑞士苏黎世大学医院）的患者（年龄≥70岁）。在急性护理入院时，采用简易营养评估法评估营养状况（评分<17=营养不良（M），≤23.5=有营养不良风险（ARM），>23.5=正常）。在同一次检查中，我们评估了精神状态（老年抑郁量表；GDS）和认知功能（简易精神状态检查表；MMSE）、衰弱状态（弗里德量表）以及合并症和用药数量。此外，记录了出院去向。所有分析均根据年龄和性别进行了调整。
共有7.1%的患者营养不良，49.1%有营养不良风险。心理健康状况较差（GDS≥5：30.5%对11.5%；P=0.004）、认知功能受损（MMSE≤26：23.6±0.5对26.0±0.6；P=0.004）、存在衰弱（32.5%对8%；P<0.001）、合并症更多（2.3±0.1对1.3±0.2；P<0.0001）以及用药更多（5.6±0.3对3.4±0.4；P<0.0001）的患者更有可能营养状况受损（M+ARM）。此外，M+ARM患者出院至非家庭目的地的可能性是其他人的两倍（优势比=2.08；置信区间1.07 - 4.05）。
在这个连续的老年创伤患者样本中，56.2%在急性护理入院时存在M+ARM，这与身体、精神和认知健康较差的指标相关，并预示着出院至非家庭目的地的可能性增加两倍多。
