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[老年创伤患者营养不良的检测:重新评估]

[Detection of malnutrition in geriatric trauma patients : A reassessment].

作者信息

Barthel J, Fischer M, Aigner R, Hack J, Bücking B, Ruchholtz S, Eschbach D

机构信息

Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH - Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland.

出版信息

Unfallchirurg. 2019 Nov;122(11):864-869. doi: 10.1007/s00113-018-0595-3.

Abstract

BACKGROUND AND OBJECTIVE

Malnutrition in geriatric trauma patients is associated with an increased risk of complications and mortality and is therefore a key risk factor. The assessment of the affected patients plays an important role in improving the outcome of this growing patient group.

MATERIAL AND METHODS

In 2016 a questionnaire was sent to 571 departments specialized in traumatology and orthopedics throughout Germany. The following were recorded: level of care, expertise in geriatric trauma, nutrition-based screening procedures and nutritional ward round procedures.

RESULTS

The response rate was 57% (n = 325) and closely reflected the treatment reality in Germany with respect to the level of care (superregional, regional or local trauma center and those without special qualifications). In 14% (n = 45) the participants were German Society for Trauma Surgery(DGU)-certified centers for age-related traumatology, while a further 5% (n = 15) were in the process of certification. The nutritional status was assessed in 56% (n = 181) of the clinics. Most frequently used was the body mass index (74%) followed by the mini nutritional assessment (30%), laboratory parameters (29%) and nutritional risk screening 2002 (19%). Some additional methods were specified. In approximately half of the departments nutritional ward rounds took place in regular wards (50%) and intensive care units (57%).

DISCUSSION

The high response rate of this study seems to show the particular interest for malnutrition in geriatric trauma patients. This is reflected in an increase in the participating clinics compared to past surveys and also the more regularly performed assessment of nutritional status and implementation of nutritional visits.

CONCLUSION

The establishment of suitable and time-effective screening instruments and their implementation are still a challenge.

摘要

背景与目的

老年创伤患者的营养不良与并发症及死亡率风险增加相关,因此是一个关键风险因素。对受影响患者的评估在改善这一不断增加的患者群体的治疗结果中起着重要作用。

材料与方法

2016年,向德国571个创伤和骨科专科科室发送了一份调查问卷。记录了以下内容:护理水平、老年创伤专业知识、基于营养的筛查程序和营养查房程序。

结果

回复率为57%(n = 325),在护理水平(超区域、区域或当地创伤中心以及无特殊资质的中心)方面密切反映了德国的治疗实际情况。14%(n = 45)的参与者是德国创伤外科学会(DGU)认证的老年创伤中心,另有5%(n = 15)正在进行认证。56%(n = 181)的诊所评估了营养状况。最常用的是体重指数(74%),其次是微型营养评定法(30%)、实验室参数(29%)和营养风险筛查2002(19%)。还指定了一些其他方法。在大约一半的科室中,营养查房在普通病房(50%)和重症监护病房(57%)进行。

讨论

本研究的高回复率似乎表明对老年创伤患者营养不良的特别关注。这体现在与过去调查相比参与诊所数量的增加,以及营养状况评估和营养查房实施的更加频繁。

结论

建立合适且高效的筛查工具及其实施仍然是一项挑战。

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