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营养风险筛查与评估

Nutritional Risk Screening and Assessment.

作者信息

Reber Emilie, Gomes Filomena, Vasiloglou Maria F, Schuetz Philipp, Stanga Zeno

机构信息

Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, and University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland.

The New York Academy of Sciences, 250 Greenwich Sweet, 40th floor, New York, NY 10007, USA.

出版信息

J Clin Med. 2019 Jul 20;8(7):1065. doi: 10.3390/jcm8071065.

Abstract

Malnutrition is an independent risk factor that negatively influences patients' clinical outcomes, quality of life, body function, and autonomy. Early identification of patients at risk of malnutrition or who are malnourished is crucial in order to start a timely and adequate nutritional support. Nutritional risk screening, a simple and rapid first-line tool to detect patients at risk of malnutrition, should be performed systematically in patients at hospital admission. Patients with nutritional risk should subsequently undergo a more detailed nutritional assessment to identify and quantify specific nutritional problems. Such an assessment includes subjective and objective parameters such as medical history, current and past dietary intake (including energy and protein balance), physical examination and anthropometric measurements, functional and mental assessment, quality of life, medications, and laboratory values. Nutritional care plans should be developed in a multidisciplinary approach, and implemented to maintain and improve patients' nutritional condition. Standardized nutritional management including systematic risk screening and assessment may also contribute to reduced healthcare costs. Adequate and timely implementation of nutritional support has been linked with favorable outcomes such as a decrease in length of hospital stay, reduced mortality, and reductions in the rate of severe complications, as well as improvements in quality of life and functional status. The aim of this review article is to provide a comprehensive overview of nutritional screening and assessment methods that can contribute to an effective and well-structured nutritional management (process cascade) of hospitalized patients.

摘要

营养不良是一个独立的风险因素,会对患者的临床结局、生活质量、身体功能和自主性产生负面影响。早期识别有营养不良风险或已营养不良的患者至关重要,以便及时启动充分的营养支持。营养风险筛查是一种简单快速的一线工具,用于检测有营养不良风险的患者,应在患者入院时系统地进行。有营养风险的患者随后应接受更详细的营养评估,以识别和量化具体的营养问题。这种评估包括主观和客观参数,如病史、当前和过去的饮食摄入(包括能量和蛋白质平衡)、体格检查和人体测量、功能和心理评估、生活质量、用药情况以及实验室检查值。应采用多学科方法制定营养护理计划,并加以实施以维持和改善患者的营养状况。包括系统风险筛查和评估在内的标准化营养管理也可能有助于降低医疗成本。充分及时地实施营养支持与诸如缩短住院时间、降低死亡率、减少严重并发症发生率以及改善生活质量和功能状态等良好结局相关。本文综述的目的是全面概述营养筛查和评估方法,这些方法有助于对住院患者进行有效且结构合理的营养管理(流程级联)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c44/6679209/5824e39e525b/jcm-08-01065-g001.jpg

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