Servicio de Endocrinología y Nutrición, Hospital Universitario de León, León, España.
Servicio de Endocrinología y Nutrición, Hospital Universitario de León, León, España.
Endocrinol Diabetes Nutr (Engl Ed). 2020 Apr;67(4):224-227. doi: 10.1016/j.endinu.2019.11.009. Epub 2020 Mar 5.
Disease-related malnutrition (DRM) is underdiagnosed and underreported despite its well-known association with a worse prognosis. The emergence of Big Data and the application of artificial intelligence in Medicine have revolutionized the way knowledge is generated. The aim of this study is to assess whether a Big Data tool could help us detect the amount of DRM in our hospital.
This was a descriptive, retrospective study using the Savana Manager® tool, which allows for automatically analyzing and extracting the relevant clinical information contained in the free text of the electronic medical record. A search was performed using the term "malnutrition", comparing the characteristics of patients with DRM to the population of hospitalized patients between January 2012 and December 2017.
Among the 180,279 hospitalization records with a discharge report in that period, only 4,446 episodes (2.47%) included the diagnosis of malnutrition. The mean age of patients with DRM was 75 years (SD 16), as compared to 59 years (SD 25) for the overall population. There were no sex differences (51% male). In-hospital death occurred in 7.08% of patients with DRM and 2.98% in the overall group. Mean stay was longer in patients with DRM (8 vs. 5 days, P<.0001) and there were no significant differences in the 72-hour readmission rate. The most common diagnoses associated with DRM were heart failure (35%), respiratory infection (23%), urinary infection (20%), and chronic kidney disease (15%).
Underdiagnosis of DRM remains a problem. Savana Manager® helps us to better understand the profile of these patients.
尽管疾病相关营养不良（DRM）与预后较差有明确关联，但它仍普遍存在诊断不足和报告不足的情况。大数据的出现和人工智能在医学中的应用彻底改变了知识产生的方式。本研究旨在评估大数据工具是否有助于我们发现医院内 DRM 的发生情况。
这是一项描述性、回顾性研究，使用了 Savana Manager®工具，该工具可自动分析和提取电子病历中的自由文本中包含的相关临床信息。使用“营养不良”一词进行搜索，将有 DRM 的患者特征与 2012 年 1 月至 2017 年 12 月住院患者人群进行比较。
在该时期有出院报告的 180279 份住院记录中，仅有 4446 例（2.47%）记录了营养不良的诊断。DRM 患者的平均年龄为 75 岁（16 岁标准差），而总体人群的平均年龄为 59 岁（25 岁标准差）。无性别差异（51%为男性）。DRM 患者的院内死亡率为 7.08%，而总体人群的死亡率为 2.98%。DRM 患者的平均住院时间较长（8 天 vs. 5 天，P<.0001），72 小时内再入院率无显著差异。与 DRM 相关的最常见诊断包括心力衰竭（35%）、呼吸道感染（23%）、尿路感染（20%）和慢性肾脏病（15%）。
DRM 的诊断不足仍然是一个问题。Savana Manager®帮助我们更好地了解这些患者的特征。
