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对中东国家一家三级医院老年患者营养状况的评估。

Assessment of nutritional status of older patients attending a tertiary hospital in Middle Eastern country.

作者信息

El Osta Nada, El Arab Haissam, Saad Robert, Rabbaa Khabbaz Lydia, Fakhouri Jihad, Papazian Tatiana, El Osta Lana

机构信息

Department of Prosthetic Dentistry, School of Dentistry, Saint-Joseph University of Beirut, Beirut, Lebanon; Department of Public Health, School of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; University of Clermont Auvergne, EA 4847, Centre de Recherche en Odontologie Clinique, BP 10448, F-63000, Clermont-Ferrand, France.

Department of Public Health, School of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.

出版信息

Clin Nutr ESPEN. 2019 Oct;33:105-110. doi: 10.1016/j.clnesp.2019.06.010. Epub 2019 Jul 8.

Abstract

BACKGROUND AND PURPOSE

In hospitals, poor nutritional status could be associated with a higher incidence of nosocomial infections, postoperative complications and mortality. Subsequently the costs of providing health care and social services will increase. Malnutrition has often been described as the skeleton in the hospital closet, as it is often ignored, undiagnosed and untreated. Our study aimed to describe the nutritional status of hospitalized patients aged 60 years or more and to evaluate the associated risk factors.

MATERIALS AND METHODS

This was an observational cross-sectional study conducted at a major tertiary teaching hospital in Beirut city. During a 7 months period, patients aged 60 and over and admitted in the medical and surgical units of the hospital were invited to participate in the study. Data were collected by means of a questionnaire including sociodemographic and medical characteristics, the Arabic version of the Mini Nutritional Assessment (MNA), the Activity of Daily Living (ADL) scale, and the American Society of Anesthesiologists (ASA) score.

RESULTS

171 participants aged 73.15 ± 8.06 years were included in the study. 52% of them were at risk of malnutrition and 13.5% were malnourished. Prevalence of malnutrition was higher in medical compared to surgical departments (16.2% vs. 10.5%, p = 0.003). Moreover, malnutrition was significantly associated with low level of education, high age, prolonged hospital stay, high number of medical comorbidities, polymedication, high ASA score and low ADL score (p < 0.05).

CONCLUSIONS

Malnutrition or risk of malnutrition are found in 2 out of 3 hospitalized patients aged 60 years or more, and is associated with several specific risk factors. Screening and management of malnutrition should be considered a priority in order to improve the overall medical status of older people, reduce hospital stay and improve outcome and quality of life.

摘要

背景与目的

在医院中,营养状况不佳可能与医院感染、术后并发症及死亡率的较高发生率相关。随之而来的是提供医疗保健和社会服务的成本将会增加。营养不良常常被形容为医院壁橱里的骷髅,因为它常常被忽视、未被诊断和未得到治疗。我们的研究旨在描述60岁及以上住院患者的营养状况,并评估相关的危险因素。

材料与方法

这是一项在贝鲁特市一家大型三级教学医院进行的观察性横断面研究。在7个月的时间里,邀请了60岁及以上且入住该医院内科和外科病房的患者参与研究。通过一份问卷收集数据,问卷内容包括社会人口统计学和医学特征、简易营养评估(MNA)阿拉伯语版、日常生活活动(ADL)量表以及美国麻醉医师协会(ASA)评分。

结果

171名年龄为73.15 ± 8.06岁的参与者被纳入研究。其中52%存在营养不良风险,13.5%为营养不良。与外科科室相比,内科的营养不良患病率更高(16.2%对10.5%,p = 0.003)。此外,营养不良与低教育水平、高龄、住院时间延长、多种内科合并症、多种药物治疗、高ASA评分及低ADL评分显著相关(p < 0.05)。

结论

在三分之二的60岁及以上住院患者中发现存在营养不良或营养不良风险,且与多种特定危险因素相关。为改善老年人的整体医疗状况、缩短住院时间并改善结局及生活质量,应将营养不良的筛查和管理视为优先事项。

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