住院老年患者吞咽困难筛查阳性与营养状况及长期死亡率的关联

Association of positive screening for dysphagia with nutritional status and long-term mortality in hospitalized elderly patients.

作者信息

Mañas-Martínez Ana B, Bucar-Barjud Marina, Campos-Fernández Julia, Gimeno-Orna José Antonio, Pérez-Calvo Juan, Ocón-Bretón Julia

机构信息

Departamento de Endocrinología y Nutrición, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.

Departamento de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.

出版信息

Endocrinol Diabetes Nutr (Engl Ed). 2018 Aug-Sep;65(7):402-408. doi: 10.1016/j.endinu.2018.02.004. Epub 2018 Apr 24.

DOI:10.1016/j.endinu.2018.02.004

PMID:29703453

Abstract

OBJECTIVES

To assess the prevalence of oropharyngeal dysphagia (OD) using the Eating Assessment Tool (EAT-10) and its association with malnutrition and long-term mortality.

MATERIAL AND METHODS

A retrospective cohort study of patients admitted to the general internal medicine ward. In the first 48hours after hospital admission, OD was assessed using the EAT-10, and presence of malnutrition with the Mini Nutritional Assessment-Short Form (MNA-SF). Association of OD to malnutrition and long-term mortality was analyzed.

RESULTS

Ninety patients with a mean age of 83 (SD: 11.8) years were enrolled. Of these, 56.7% were at risk of OD according to EAT-10. This group of patients had greater prevalence rates of malnutrition (88.2% vs. 48.7%; P=.001) and mortality (70% vs 35.9%; P=.001). During follow-up for 872.71 (SD: 642.89) days, risk of DO according to EAT-10 was an independent predictor of mortality factor in a multivariate analysis (HR: 2.8; 95%CI: 1.49-5.28; P=.001).

CONCLUSIONS

The EAT-10 is a useful tool for screening OD. Adequate screening for OD is important because of its associated risks of malnutrition and long-term mortality.

摘要

目的

使用饮食评估工具（EAT-10）评估口咽吞咽困难（OD）的患病率及其与营养不良和长期死亡率的关联。

材料与方法

对入住普通内科病房的患者进行回顾性队列研究。在入院后的头48小时内，使用EAT-10评估OD，并使用微型营养评定简表（MNA-SF）评估营养不良情况。分析OD与营养不良和长期死亡率的关联。

结果

纳入了90名平均年龄为83岁（标准差：11.8）的患者。其中，根据EAT-10，56.7%的患者有OD风险。这组患者的营养不良患病率（88.2%对48.7%；P=0.001）和死亡率（70%对35.9%；P=0.001）更高。在872.71天（标准差：642.89）的随访期间，根据EAT-10得出的吞咽困难风险在多变量分析中是死亡率的独立预测因素（风险比：2.8；95%置信区间：1.49-5.28；P=0.001）。