Department of Nutrition, Aichi Medical University Hospital, Nagakute 480-1195, Japan.
Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan.
Nutrients. 2020 Feb 20;12(2):541. doi: 10.3390/nu12020541.
Malnutrition leads to poor prognoses, including a predisposition to falls. Few studies have investigated the relationship between malnutrition and falls during hospitalization. This study aimed to determine malnutrition's association with falls during hospitalization. A retrospective observational study was conducted. Patients aged ≥65 years that were admitted to and discharged from a university hospital between April 2018 and March 2019 were examined. Patients with independent basic activities of daily living were included. Diagnosis of malnutrition was based on the European Society for Clinical Nutrition and Metabolism (ESPEN) criteria at admission. Disease information such as the Charlson Comorbidity Index (CCI) and reasons for hospitalization were reviewed. Kaplan-Meier curve and multivariate Cox regression analyses were performed. Data from 6081 patients (mean age: 74.4 ± 6.1 years; males: 58.1%) were analyzed. The mean CCI was 2.3 ± 2.8 points. Malnutrition was detected in 668 (11.0%) and falls occurred in 55 (0.9%) patients. Malnourished patients experienced a higher fall rate than those without malnutrition (2.4% vs. 0.7%, log-rank test < 0.001). In multivariate analysis, malnutrition had the highest hazard ratio for falls among covariates (hazard ratio 2.78, 95% confidence interval 1.51-5.00, = 0.001). In conclusion, malnutrition at the time of admission to hospital predicts in-hospital falls.
营养不良导致预后不良，包括易发生跌倒。很少有研究调查住院期间营养不良与跌倒之间的关系。本研究旨在确定营养不良与住院期间跌倒的关系。进行了一项回顾性观察性研究。检查了 2018 年 4 月至 2019 年 3 月期间在一所大学医院住院和出院的年龄≥65 岁的患者。包括具有独立基本日常生活活动能力的患者。营养不良的诊断依据入院时欧洲临床营养与代谢学会（ESPEN）标准。回顾了疾病信息，如 Charlson 合并症指数（CCI）和住院原因。进行了 Kaplan-Meier 曲线和多变量 Cox 回归分析。分析了 6081 名患者（平均年龄：74.4±6.1 岁；男性：58.1%）的数据。平均 CCI 为 2.3±2.8 分。在 668 名（11.0%）患者中发现营养不良，55 名（0.9%）患者发生跌倒。营养不良患者的跌倒发生率高于无营养不良患者（2.4%比 0.7%，log-rank 检验<0.001）。在多变量分析中，营养不良在协变量中对跌倒的危害比最高（危害比 2.78，95%置信区间 1.51-5.00，=0.001）。总之，入院时的营养不良预测住院期间的跌倒。
