Centre for Research in Geriatric Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
Nutr Diet. 2018 Feb;75(1):11-16. doi: 10.1111/1747-0080.12391. Epub 2017 Nov 22.
Nutritional screening may not always lead to intervention. The present study aimed to determine: (i) the rate of nutritional screening in hospitalised older adults; (ii) whether nutritional screening led to dietitian consultation and (iii) factors associated with malnutrition.
In this prospective study of patients aged ≥70 years admitted to a Geriatric Evaluation and Management Unit (GEMU), malnutrition was screened for using the Mini Nutritional Assessment Short Form (MNA-SF) and identified using the Mini Nutritional Assessment (MNA).
Of the 172 patients participating in the study, 53 (30.8%) patients were malnourished, and 84 (48.8%) were at risk of malnutrition. Mean (SD) age was 85.2 (6.4 years), with 131 patients (76.2%) female. Nutritional screening was performed for all patients; however, it was incomplete in 59 (34.3%) because of omission of the anthropometric measurement. Overall, 62 (36.0%) of the total number of patients were seen by the dietitian, which included 26 (49%) of malnourished patients, 27 (32%) of at-risk patients and 9 (26%) of the well-nourished patients. No patients lost >1% of body weight during GEMU stay. Malnourished patients were more likely to be frail, have poor appetite, depression, and have lower levels of: albumin, cognition, physical function, grip strength and quality of life.
The full benefits of nutritional screening by MNA-SF may not be realised if it does not result in malnourished patients receiving a dietitian consultation. However, it is possible that enrichment of the foodservice with high protein/high-energy options minimised patient weight loss in the GEMU.
营养筛查并不总能导致干预。本研究旨在确定:(i)住院老年人营养筛查的发生率;(ii)营养筛查是否导致营养师咨询;(iii)与营养不良相关的因素。
在这项对≥70 岁入住老年评估和管理病房(GEMU)的患者的前瞻性研究中,使用微型营养评估简表(MNA-SF)筛查营养不良,并使用微型营养评估(MNA)进行确认。
在参与研究的 172 名患者中,53 名(30.8%)患者存在营养不良,84 名(48.8%)存在营养不良风险。平均(SD)年龄为 85.2(6.4)岁,131 名(76.2%)患者为女性。对所有患者进行了营养筛查;然而,由于忽略了人体测量学测量,有 59 名(34.3%)患者的筛查不完整。总的来说,共有 62 名(36.0%)患者接受了营养师的治疗,其中包括 26 名(49%)营养不良患者、27 名(32%)存在营养不良风险的患者和 9 名(26%)营养良好的患者。在 GEMU 住院期间,没有患者体重减轻超过 1%。营养不良患者更有可能虚弱、食欲不振、抑郁,且白蛋白、认知、身体功能、握力和生活质量较低。
如果 MNA-SF 进行的营养筛查不能导致营养不良患者接受营养师咨询,那么营养筛查的全部益处可能无法实现。然而,通过丰富高蛋白质/高能量的饮食选择,可能使 GEMU 中的患者体重减轻最小化。