EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal.
Serviço de Nutrição e Dietética, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal.
Pulmonology. 2018 Nov-Dec;24(6):330-336. doi: 10.1016/j.pulmoe.2018.01.004. Epub 2018 Mar 19.
There is a lack of evidence regarding the association between the undernutrition risk at hospital admission with adverse clinical outcomes amongst pulmonology inpatients. The aim of this study was to quantify the association between undernutrition risk at hospital admission and time to discharge alive.
A retrospective cohort study including patients consecutively admitted to a pulmonology unit was conducted. Undernutrition risk at hospital admission was identified using the Malnutrition Universal Screening Tool. Survival analyses (Kaplan-Meier curves and Cox regression) were carried out.
The sample was composed of 683 patients. Patients who presented high undernutrition risk on hospital admission had a longer length of hospital stay (approximately 50% were discharged to home after 14 days of hospitalization). In the multivariable Cox regression, high undernutrition risk was shown to be independently associated with a lower probability of discharge alive over time (adjusted hazard ratio=0.70; 95% confidence interval: 0.55-0.90).
Pulmonology inpatients with high undernutrition risk have a longer length of hospital stay and had a lower probability of being discharged to home. In particular, lung cancer patients had a lower probability of being discharged to home, which corroborates a worse prognosis for these patients.
目前缺乏关于入院时营养不良风险与肺病住院患者不良临床结局之间关联的证据。本研究旨在定量评估入院时营养不良风险与存活至出院时间之间的关联。
本研究为回顾性队列研究，纳入了连续收治于肺病科的患者。入院时营养不良风险使用营养不良通用筛查工具进行评估。采用生存分析（Kaplan-Meier 曲线和 Cox 回归）进行分析。
该样本由 683 名患者组成。入院时存在高营养不良风险的患者住院时间更长（约有 50%的患者在住院 14 天后出院回家）。在多变量 Cox 回归中，高营养不良风险与存活至出院时间的概率降低独立相关（调整后的危险比=0.70；95%置信区间：0.55-0.90）。
患有高营养不良风险的肺病住院患者的住院时间更长，存活至出院回家的概率更低。特别是肺癌患者出院回家的概率更低，这表明这些患者的预后更差。
