Leiva Badosa Elisabet, Badia Tahull Maria, Virgili Casas Núria, Elguezabal Sangrador Gema, Faz Méndez Concepción, Herrero Meseguer Ignacio, Izquierdo González Àngels, López Urdiales Rafael, Oca Burguete Francisco Javier, Tubau Molas María, Vilarasau Farré Concepció, Llop Talaveron Josep Manel
Hospital Universitari de Bellvitge. IDIBELL..
Nutr Hosp. 2017 Jul 28;34(4):907-913. doi: 10.20960/nh.657.
Malnutrition is common in patients admitted to hospital and is associated with morbidity and mortality. We conducted a study to assess the prevalence of nutritional risk, risk factors associated and its consequences in a third-level hospital.
This is a prospective nutritional screening study of hospitalized patients evaluated within the first 72 hours of admission, by Malnutrition Universal Screening Tool (MUST) and Short Nutritional Assessment Questionnaire (SNAQ) screening tests. The variables recorded included demographic, anthropometric, hospitalization and clinical data.
Out of 409 patients, 12.7% and 15.3% were nutritionally at risk according to MUST and SNAQ, respectively, with the highest prevalence in critical care units (33.3%; 25.5%), amongst oncologic patients (17.5%; 28.4%) and those with higher Charlson comorbidity indices (CCI). Length of stay (LOS) was longer in patients at severe malnutrition risk (15.4 vs 9.9 days for MUST; 13.3 vs 9.9 days for SNAQ). Mortality was higher in those with high malnutrition risk (66.7% vs 10.9% for MUST; 50.0% vs 14.2% for SNAQ). Multivariate analysis showed that malnutrition was associated with CCI and mortality. Risk factors associated with LOS were admission as emergencies for both MUST and SNAQ tests.
The prevalence of malnutrition is high in patients on admission to a third-level hospital, with a higher prevalence in critical care units, amongst oncologic patients and those with a higher CCI. Malnutrition is associated with longer LOS and higher mortality. The systematic clinical use of screening tools enables to detect patients at risk of malnutrition and take appropriate action.
营养不良在住院患者中很常见，且与发病率和死亡率相关。我们开展了一项研究，以评估一家三级医院中营养风险的患病率、相关危险因素及其后果。
这是一项对住院患者进行的前瞻性营养筛查研究，在入院的前72小时内通过营养不良通用筛查工具（MUST）和简短营养评估问卷（SNAQ）筛查测试进行评估。记录的变量包括人口统计学、人体测量学、住院情况和临床数据。
在409例患者中，根据MUST和SNAQ评估，分别有12.7%和15.3%的患者存在营养风险，在重症监护病房中患病率最高（分别为33.3%和25.5%），在肿瘤患者中（分别为17.5%和28.4%）以及Charlson合并症指数（CCI）较高的患者中患病率也较高。存在严重营养不良风险的患者住院时间更长（MUST评估为15.4天对9.9天；SNAQ评估为13.3天对9.9天）。营养不良风险高的患者死亡率更高（MUST评估为66.7%对10.9%；SNAQ评估为50.0%对14.2%）。多因素分析表明，营养不良与CCI和死亡率相关。与住院时间相关的危险因素是MUST和SNAQ测试均以急诊入院。
三级医院入院患者中营养不良的患病率很高，在重症监护病房、肿瘤患者以及CCI较高的患者中患病率更高。营养不良与更长的住院时间和更高的死亡率相关。系统地临床使用筛查工具能够检测出有营养不良风险的患者并采取适当措施。
