a Area di Geriatria , Università Campus Bio-Medico di Roma , Rome , Italy.
b Parc Sanitari Pere Virgili , Barcelona , Spain.
J Am Coll Nutr. 2019 Jul;38(5):441-446. doi: 10.1080/07315724.2018.1541427. Epub 2019 Jan 24.
Evidence about the role of nutritional status (NS) on functional outcomes (FO) after rehabilitation in older adults is scarce. Our aim was to analyze the association between NS and FO in older adults admitted to geriatric rehabilitation units. The Sarcopenia And Function in Aging Rehabilitation (SAFARI) multicenter study enrolled patients aged ≥65 years admitted to geriatric rehabilitation units in Italy and Spain. FO were absolute and relative functional gain (AFG-RFG) in Barthel Index (BI) at 1 and 3 months after admission. The association between NS (Mini Nutritional Assessment-Short Form) and FO was explored using linear regression and mixed models, adjusted for potential confounders. Analyses were then stratified for diagnosis at admission. We included 415 patients (mean age 81.4 years [SD: 7.7]; 67% female; 9.4% malnourished [MN], 42.7% at risk of malnutrition [RM], and 48% well nourished [WN]). Admission diagnoses were hip fracture (39.5%), elective orthopedic surgery (EOS) (29.5%), and stroke (31%). In an adjusted linear mixed model, MN and RM participants had lower BI compared to WN (MN: β: -8.47, = 0.023; RM: β: -5.22, = 0.031), and differences between groups remained stable over time. After stratification for admission diagnosis, only MN patients admitted after EOS had worse FO, both at 30 days (AFG: β adjusted: -13.54, < 0.001; RFG: β: -32, < 0.001) and 3 months (AFG: β adjusted: -17.79, < 0.001; RFG: β: -26.77, = 0.002). In our sample, poor NS is associated with worse BI in older adults admitted to geriatric rehabilitation units; in patients undergoing EOS, MN is associated with worse FO. Our results documented for the first time the importance of assessing nutritional status before EOS.
关于营养状况（NS）对老年人康复后功能结果（FO）的作用的证据很少。我们的目的是分析老年康复病房中老年人 NS 与 FO 之间的关系。肌少症和衰老康复的功能和营养评估（SAFARI）多中心研究纳入了意大利和西班牙老年康复病房收治的年龄≥65 岁的患者。FO 是入院后 1 个月和 3 个月时 Barthel 指数（BI）的绝对和相对功能增益（AFG-RFG）。使用线性回归和混合模型，根据潜在的混杂因素调整，探讨 NS（迷你营养评估-短表）与 FO 之间的关系。然后根据入院时的诊断进行分层分析。 我们纳入了 415 名患者（平均年龄 81.4 岁[标准差：7.7]；67%为女性；9.4%为营养不良[MN]，42.7%为营养不良风险[RM]，48%为营养良好[WN]）。入院诊断为髋部骨折（39.5%）、择期骨科手术（EOS）（29.5%）和中风（31%）。在调整后的线性混合模型中，与 WN 相比，MN 和 RM 参与者的 BI 较低（MN：β：-8.47，P=0.023；RM：β：-5.22，P=0.031），且组间差异随时间保持稳定。在按入院诊断分层后，仅 EOS 后入院的 MN 患者 FO 较差，在 30 天（AFG：β调整：-13.54，P<0.001；RFG：β：-32，P<0.001）和 3 个月（AFG：β调整：-17.79，P<0.001；RFG：β：-26.77，P=0.002）时均如此。 在我们的样本中，老年康复病房中老年人 NS 较差与 BI 较差相关；在接受 EOS 的患者中，MN 与 FO 较差相关。我们的研究结果首次记录了在 EOS 前评估营养状况的重要性。
