Hospital of the University of Pennsylvania, Philadelphia, PA.
University of Southern California, Los Angeles, CA.
Clin Lymphoma Myeloma Leuk. 2019 Jul;19(7):e393-e398. doi: 10.1016/j.clml.2019.04.002. Epub 2019 Apr 6.
Autologous stem cell transplantation (ASCT) patients are at risk for malnutrition before transplantation admission as well as malnutrition acquired during their transplantation admission.
In this retrospective, observational study we examined data related to consecutive adults (n = 330) admitted for ASCT between 2014 and 2016 at the Hospital of the University of Pennsylvania. Malnutrition risk on admission (identified by the Malnutrition Screening Tool) and transplantation-associated weight loss were analyzed for independent associations with hospital length of stay, nosocomial infection, intensive care unit transfer, deconditioning, time to platelet and neutrophil engraftment, 30-day readmission, and 1-year mortality.
Adults with high malnutrition risk (n = 60) had a longer median hospital stay (P = .004), longer median time to platelet engraftment (P = .022), increased nosocomial infections (P = .047), and increased 1-year mortality (P = .036). Adults with high transplantation-associated weight loss (n = 100) experienced longer hospital stays (P < .001) and more intensive care unit transfers (P = .001). Outcomes for deconditioning, time to neutrophil engraftment, and 30-day readmission did not differ significantly on the basis of nutrition risk or weight loss.
Further research is needed to determine whether early nutrition intervention would improve these outcomes.
自体干细胞移植 (ASCT) 患者在移植入院前以及在移植期间存在营养不良的风险。
在这项回顾性观察研究中，我们检查了 2014 年至 2016 年间在宾夕法尼亚大学医院连续收治的 330 例成人 ASCT 患者的数据。分析入院时的营养不良风险（通过营养不良筛查工具确定）和与移植相关的体重减轻与住院时间、医院获得性感染、重症监护病房转科、失代偿、血小板和中性粒细胞植入时间、30 天再入院和 1 年死亡率之间的独立相关性。
高营养不良风险的成年人（n=60）的中位住院时间较长（P=0.004），血小板植入中位时间更长（P=0.022），医院获得性感染增加（P=0.047），1 年死亡率增加（P=0.036）。高与移植相关的体重减轻的成年人（n=100）经历了更长的住院时间（P<0.001）和更多的重症监护病房转科（P=0.001）。失代偿、中性粒细胞植入时间和 30 天再入院的结果在营养风险或体重减轻方面没有显著差异。
需要进一步研究以确定早期营养干预是否会改善这些结果。
