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巴西住院患者营养不良和发生压疮的风险:多中心前瞻性队列研究。

Risk for undernutrition and development of pressure injury in hospitalised patients in Brazil: Multicentre prospective cohort study.

机构信息

Faculty of Education in Health Sciences (FECS), Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.

Nursing School, Universidade de Sao Paulo (USP), São Paulo, Brazil.

出版信息

Int Wound J. 2020 Aug;17(4):916-924. doi: 10.1111/iwj.13352. Epub 2020 Mar 29.

Abstract

Although pressure injury (PI) is preventable, the number of patients developing this type of injury is still high. In this prospective cohort study, we aimed to assess whether high risk for undernutrition was a risk factor for PI in 1937 patients aged ≥18 at six hospitals in Sao Paulo, Brazil. Patients' risk for undernutrition was assessed using three unique screening tools. Risk for PI was assessed using the Braden Scale. Data were analysed using Poisson regression with robust variance (95% CI, P ≤ .05). While 57.1% of patients were at risk for undernutrition in the Nutritional Risk Screening (NRS 2002), only 36.8% and 2.6% were at risk in the Braden Scale Nutrition Subscale (BSNS) and Subjective Global Assessment of Nutritional Status (SGANS), respectively. The cumulative incidence rate was 5.9%. Of those who developed PI, 91.2%, 56.2%, and 18.4% were at risk for undernutrition in the NRS 2002, BSNS, and SGANS scales, respectively. We found a significantly higher risk for PI in patients who were at risk for undernutrition compared with those who were not at risk, supporting previous evidence about the role of undernutrition as a key risk factor for PI in hospitalised patients.

摘要

尽管压力性损伤(PI)是可以预防的,但仍有大量患者发生这种类型的损伤。在这项前瞻性队列研究中,我们旨在评估在巴西圣保罗的六家医院中,1937 名年龄≥18 岁的患者中,营养不足高风险是否是 PI 的一个危险因素。使用三种独特的筛选工具评估患者的营养不足风险。使用布雷登量表评估 PI 风险。使用泊松回归分析具有稳健方差(95%CI,P ≤.05)。虽然 57.1%的患者在营养风险筛查(NRS 2002)中存在营养不足风险,但仅 36.8%和 2.6%的患者在布雷登量表营养亚量表(BSNS)和主观整体评估营养状况(SGANS)中存在风险。累积发病率为 5.9%。在发生 PI 的患者中,91.2%、56.2%和 18.4%在 NRS 2002、BSNS 和 SGANS 量表中存在营养不足风险,分别。与无风险患者相比,存在营养不足风险的患者发生 PI 的风险显著更高,这支持了之前关于营养不足是住院患者 PI 的一个关键危险因素的证据。

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