Zhu Mingwei, Wei Junmin, Chen Wei, Yang Xin, Cui Hongyuan, Zhu Sainan
a Department of General Surgery , Beijing Hospital , Beijing , China.
b Department of Parenteral and Enteral Nutrition , Peking Union Medical College Hospital , Beijing , China.
J Am Coll Nutr. 2017 Jul;36(5):357-363. doi: 10.1080/07315724.2017.1304293. Epub 2017 May 26.
The objective of this study was to assess nutritional risk and status of Chinese hospitalized patients at admission and discharge and relations with clinical outcomes.
A prospective, nationwide, multicenter study was conducted from June to September 2014 in 34 large hospitals in 18 cities in China. Patients ≥ 18 years with a hospital stay of 7-30 days were recruited. Anthropometric and laboratory indicators, nutritional risk screening, and assessment by Nutritional Risk Screening 2002 (NRS 2002) and subjective global assessment (SGA) were performed within 24 hours of admission and discharge. Clinical data during hospitalization were collected.
A total of 6,638 patients met the criteria with a male: female ratio of 1.39:1 and an average age of 59.72 ± 15.40 years. At admission, the proportion of patients with nutritional risk, body mass index (BMI) < 18.5 kg/m, and moderate to severe malnutrition was 40.12%, 8.92%, and 26.45%, respectively, whereas at discharge, these percentages were 42.28%, 8.91%, and 30.57%, respectively. The values of all of these indicators were higher in patients 65 years of age and older. Patients with nutritional risk at admission had a longer average hospital stay (14.02 ± 6.42 vs 13.09 ± 5.703 days), higher incidence of total complications (6.90% vs 1.52%), and greater total medical expenses (3.39 ± 7.50 vs 3.00 ± 3.38 million RMB; all p < 0.01) than patients without nutritional risk. Similar results were obtained for the patients with nutritional risk at discharge.
The prevalence of nutritional risk and malnutrition, including moderate to severe malnutrition, at discharge is higher than that observed at admission; the clinical outcome of patients with nutritional risk is poor.
本研究旨在评估中国住院患者入院时和出院时的营养风险与状况，以及与临床结局的关系。
2014年6月至9月在中国18个城市的34家大型医院进行了一项前瞻性、全国性、多中心研究。招募住院时间为7至30天的18岁及以上患者。在入院和出院后24小时内进行人体测量和实验室指标检测、营养风险筛查，并采用营养风险筛查2002（NRS 2002）和主观全面评定法（SGA）进行评估。收集住院期间的临床资料。
共有6638例患者符合标准，男女比例为1.39:1，平均年龄为59.72±15.40岁。入院时，存在营养风险、体重指数（BMI）<18.5 kg/m²以及中度至重度营养不良的患者比例分别为40.12%、8.92%和26.45%，而出院时这些比例分别为42.28%、8.91%和30.57%。所有这些指标在65岁及以上患者中更高。入院时存在营养风险的患者平均住院时间更长（14.02±6.42天 vs 13.09±5.703天），总并发症发生率更高（6.90% vs 1.52%），总医疗费用更高（33.9±75.0万元 vs 30.0±33.8万元；均p<0.01），高于无营养风险的患者。出院时存在营养风险的患者也得到了类似结果。
出院时营养风险和营养不良（包括中度至重度营养不良）的患病率高于入院时；存在营养风险的患者临床结局较差。
