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营养状况对老年患者髋部骨折6个月预后的影响

Effects of Nutritional Status on 6-Month Outcome of Hip Fractures in Elderly Patients.

作者信息

Miu Ka Ying Doris, Lam Pui Shan

机构信息

Department of Rehabilitation and Extended Care, Wong Tai Sin Hospital, Hong Kong.

出版信息

Ann Rehabil Med. 2017 Dec;41(6):1005-1012. doi: 10.5535/arm.2017.41.6.1005. Epub 2017 Dec 28.

Abstract

OBJECTIVE

To identify the prevalence of malnutrition in elderly hip fracture and to investigate the relationship between hip fracture patients and malnutrition on functional recovery and mortality.

METHODS

All hip fracture patients age >65 years admitted to a rehabilitation unit were recruited from July 2015 to June 2016. Nutritional status was assessed by Mini-Nutritional Assessment Short-Form (MNA-SF) within 72 hours of admission. Patients were reassessed at 6 months for functional status and place of residence. Length of hospital stay, in-patient mortality rate, and 6-month mortality rate were also recorded.

RESULTS

There were 218 patients recruited. The mean age was 83.5±7.5 years. According the MNA-SF, 46 (21.1%) were well nourished, 115 (52.6%) were at risk of malnutrition, and 57 (26.1%) were malnourished. Malnourished individuals were significantly older, had lower Mini-Mental State Examination score and albumin level, were functionally more dependent and were more likely to reside in elderly care facility. A higher proportion of elderly care residents were at-risk or were malnourished on admission, discharge and at 6 months. Functional recovery was slower in the malnourished group. In-patient mortality was higher in malnourished individuals compared to those at risk of malnourishment and well-nourished individuals.

CONCLUSION

The prevalence of malnutrition is high and is associated with poor functional recovery and elderly care placement. Residents of elderly care facilities are especially at risk due a higher prevalence of malnourishment. Health authorities are encouraged to evaluate the dietetic component in elderly care facilities and initiate nutrition supplementation in their planning of healthcare resources.

摘要

目的

确定老年髋部骨折患者中营养不良的患病率,并调查髋部骨折患者与营养不良之间在功能恢复和死亡率方面的关系。

方法

选取2015年7月至2016年6月入住康复科的所有年龄>65岁的髋部骨折患者。入院72小时内采用微型营养评定法简表(MNA-SF)评估营养状况。在6个月时对患者的功能状态和居住地点进行重新评估。记录住院时间、住院死亡率和6个月死亡率。

结果

共招募了218例患者。平均年龄为83.5±7.5岁。根据MNA-SF评估,46例(21.1%)营养状况良好,115例(52.6%)存在营养不良风险,57例(26.1%)营养不良。营养不良的个体年龄显著更大,简易精神状态检查表得分和白蛋白水平更低,功能上更依赖他人,且更有可能居住在老年护理机构。在入院、出院和6个月时,老年护理机构的居民中处于风险或营养不良的比例更高。营养不良组的功能恢复较慢。与存在营养不良风险的个体和营养状况良好的个体相比,营养不良个体的住院死亡率更高。

结论

营养不良的患病率很高,且与功能恢复不佳和入住老年护理机构有关。老年护理机构的居民由于营养不良患病率较高,尤其面临风险。鼓励卫生当局评估老年护理机构的饮食组成部分,并在其医疗资源规划中启动营养补充措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6038/5773420/7f5b636a110a/arm-41-1005-g001.jpg

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