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509 例急性髋部骨折患者队列中的营养不良患病率:全面评估的重要性。

Prevalence of malnutrition in a cohort of 509 patients with acute hip fracture: the importance of a comprehensive assessment.

机构信息

Geriatrics Department, Hospital Universitario La Paz, Madrid, Spain.

La Paz University Hospital Research Institute, IdiPAZ, Madrid, Spain.

出版信息

Eur J Clin Nutr. 2018 Jan;72(1):77-81. doi: 10.1038/ejcn.2017.72. Epub 2017 May 17.

Abstract

UNLABELLED

Backgrounds/objectives:Malnutrition is very common in acute hip fracture (HF) patients. Studies differ widely in their findings, with reported prevalences between 31 and 88% mainly because of small sample sizes and the use of different criteria. The aim of this study was to learn the prevalence of malnutrition in a large cohort of HF patients in an comprehensive way that includes the frequency of protein-energy malnutrition, vitamin D deficiency and sarcopenia.

SUBJECTS/METHODS: A 1-year consecutive sample of patients admitted with fragility HF in a 1300-bed public University Hospital, who were assessed within the first 72 h of admission. Clinical, functional, cognitive and laboratory variables were included. Energy malnutrition (body mass index (BMI) <22 kg/m), protein malnutrition (serum total protein <6.5 g/dl or albumin <3.5 g/dl), vitamin D deficiency (serum 25-OH-vitamin D <30 ng/dl) and sarcopenia (low muscle mass plus low grip strength) were considered.

RESULTS

Five hundred nine HF patients were included. The mean age was 85.6±6.9 years and 79.2% were women. Ninety-nine (20.1%) patients had a BMI <22 kg/m. Four hundred nine patients (81.2%) had protein malnutrition. Eighty-seven (17.1%) patients had both energy and protein malnutrition. Serum vitamin D was <30 ng/ml in 466 (93%) patients. The prevalence of sarcopenia was 17.1%.

CONCLUSIONS

Protein malnutrition and vitamin D deficiency are the rule in acute HF patients. Energy malnutrition and sarcopenia are also common. A nutritional assessment in these patients should include these aspects together.

摘要

背景/目的:营养不良在急性髋部骨折(HF)患者中非常常见。由于样本量小和使用不同标准,研究结果差异很大,报告的患病率在 31%至 88%之间。本研究旨在全面了解大量 HF 患者的营养不良患病率,包括蛋白质-能量营养不良、维生素 D 缺乏和肌肉减少症的频率。

受试者/方法:这是一项在一家拥有 1300 张床位的公立大学医院连续收治的 1 年内因脆性 HF 入院的患者的研究,在入院后 72 小时内进行评估。纳入了临床、功能、认知和实验室变量。能量营养不良(体重指数(BMI)<22kg/m)、蛋白质营养不良(血清总蛋白<6.5g/dl 或白蛋白<3.5g/dl)、维生素 D 缺乏(血清 25-羟维生素 D <30ng/dl)和肌肉减少症(低肌肉量加上低握力)被认为是营养不良。

结果

共纳入 509 例 HF 患者。平均年龄为 85.6±6.9 岁,79.2%为女性。99 例(20.1%)患者 BMI<22kg/m。409 例(81.2%)患者有蛋白质营养不良。87 例(17.1%)患者同时存在能量和蛋白质营养不良。466 例(93%)患者血清维生素 D<30ng/ml。肌肉减少症的患病率为 17.1%。

结论

急性 HF 患者中普遍存在蛋白质营养不良和维生素 D 缺乏。能量营养不良和肌肉减少症也很常见。这些患者的营养评估应包括这些方面。

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