Babb Ellen B, Rohrer James
SC WIC, Columbia, SC, USA.
Sage Pubs, Thousand Oaks, CA, USA.
J Eval Clin Pract. 2017 Dec;23(6):1211-1217. doi: 10.1111/jep.12762. Epub 2017 Jun 16.
RATIONALE, AIMS, AND OBJECTIVES: Improving the nutritional status of hospitalized patients has been shown to reduce length of stay (LOS), hospital costs, readmission rates, complication rates, and mortality. Provision of nutrient-rich, liquid, oral nutrition supplements (ONS) is one approach to improve nutritional status. Little information is available on ONS use and LOS among heart failure patients.
This study used a retrospective design to examine whether routine ONS use was associated with hospital LOS among 570 heart failure inpatients (89 ONS = yes; 481 ONS = no) at a regional medical center, adjusting for significant personal, locational, and time variables using multiple logistic regression analysis.
Oral nutrition supplement use was associated with high LOS in this sample (odds ratio = 2.43). High LOS was also associated with higher Charlson comorbidity index values, discharge destination, hospital room location, and dietitian consults.
These results show that ONS orders alone are not adequate to reduce LOS among heart failure patients. Continued research is needed on ways to improve care to reduce LOS among hospitalized patients.
原理、目的和目标:已有研究表明,改善住院患者的营养状况可缩短住院时间(LOS)、降低住院费用、再入院率、并发症发生率和死亡率。提供营养丰富的液体口服营养补充剂(ONS)是改善营养状况的一种方法。关于心力衰竭患者使用ONS与住院时间的信息较少。
本研究采用回顾性设计,以检验在一家地区医疗中心的570例心力衰竭住院患者(89例使用ONS = 是;481例使用ONS = 否)中,常规使用ONS是否与住院时间相关,并使用多元逻辑回归分析对重要的个人、地点和时间变量进行调整。
在该样本中,使用口服营养补充剂与住院时间长相关(比值比 = 2.43)。住院时间长还与较高的查尔森合并症指数值、出院目的地、病房位置和营养师会诊有关。
这些结果表明,仅开具ONS医嘱不足以缩短心力衰竭患者的住院时间。需要继续研究改善护理的方法,以缩短住院患者的住院时间。