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营养支持团队的治疗指征与营养状况之间的关联。

Association between indication for therapy by nutrition support team and nutritional status.

作者信息

Shin Byung Chul, Chun In Ae, Ryu So Yeon, Oh Ji Eun, Choi Pahn Kyu, Kang Hyun Goo

机构信息

Department of Nutritional Service Team.

Department of Internal Medicine.

出版信息

Medicine (Baltimore). 2018 Dec;97(52):e13932. doi: 10.1097/MD.0000000000013932.

Abstract

The nutrition support team is a multidisciplinary team composed of medical doctors, registered nurses, pharmacists, and nutritionists, who evaluate the nutritional status of patients. The objective of this study was to determine the relationship between indications for nutrition support team therapy and the nutritional status of patients hospitalized in local major hospitals.Patients who were referred to a nutrition support team from January to December 2016 were enrolled. Patients were classified into 4 age groups, and the weight categories were determined using body mass index (BMI). Four of 6 indications were used for referral to a nutrition support team. The required calories were estimated, and the nutritional status was classified into malnutrition or eutrophia, based on the estimation.The proportion of elderly patients (37.0%) was higher than that of younger ones (28.3%). Patients with higher BMI had a relatively lower proportion of malnutrition. Patients receiving enteral nutrition had greater risk of malnutrition (adjusted odds ratio [aOR] = 3.77, 95% confidence interval [CI] = 2.71-5.24). Patients receiving parenteral nutrition (aOR = 0.38, 95% CI = 0.30-0.47) and treated in the intensive care unit (aOR = 0.70, 95% CI = 0.54-0.91) had lower risk of malnutrition. Patients with >3 indications for nutrition support team therapy had a lower risk of malnutrition than those with only 1 indication (aOR = 0.54, 95% CI = 0.37-0.77).Parenteral nutrition was the most common indication for referral to nutrition support team therapy; however, enteral nutrition had the poorest nutritional status. Patients receiving enteral nutrition who are referred to a nutrition support team need an intensive nutrition support strategy.

摘要

营养支持团队是一个由医生、注册护士、药剂师和营养师组成的多学科团队,负责评估患者的营养状况。本研究的目的是确定营养支持团队治疗指征与当地大型医院住院患者营养状况之间的关系。

纳入了2016年1月至12月被转诊至营养支持团队的患者。患者被分为4个年龄组,并使用体重指数(BMI)确定体重类别。6项转诊至营养支持团队的指征中有4项被采用。估算所需热量,并根据估算结果将营养状况分为营养不良或营养正常。

老年患者的比例(37.0%)高于年轻患者(28.3%)。BMI较高的患者营养不良比例相对较低。接受肠内营养的患者营养不良风险更高(调整优势比[aOR]=3.77,95%置信区间[CI]=2.71-5.24)。接受肠外营养的患者(aOR=0.38,95%CI=0.30-0.47)和在重症监护病房接受治疗的患者(aOR=0.70,95%CI=0.54-0.91)营养不良风险较低。营养支持团队治疗指征>3项的患者比只有1项指征的患者营养不良风险更低(aOR=0.54,95%CI=0.37-0.77)。

肠外营养是转诊至营养支持团队治疗最常见的指征;然而,肠内营养的营养状况最差。被转诊至营养支持团队的接受肠内营养的患者需要强化营养支持策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/111f/6314734/ae1040f22ef0/medi-97-e13932-g001.jpg

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