Center for Nutrition and Bowel Disease, Aalborg University Hospital, Aalborg, Denmark.
Department of Health Science and Technology, Aalborg University, Aalborg Denmark.
Nutrition. 2020 Jul-Aug;75-76:110747. doi: 10.1016/j.nut.2020.110747. Epub 2020 Feb 11.
Disease-related malnutrition (DRM) in hospitalized patients is known to have significant negative impact on clinical outcomes. Meanwhile, DRM in gastroenterology outpatients is scarcely investigated. The aim of this study was to investigate the prevalence of unintentional weight loss (UWL) and reduced food intake (RFI) as contributors to the risk of DRM in outpatients. Furthermore, the aim was to investigate if UWL may be used as initial screening for DRM, based on the correlation between UWL and RFI.
All outpatients visiting the clinics for Medical and Surgery Gastroenterology, Aalborg University Hospital, Denmark, during 1 wk in September 2018, were invited to participate. Data regarding UWL within the past 3 mo, RFI the past week, and nutritional impact symptoms (NIS) were collected in this questionnaire-based cross-sectional study. Descriptive analysis, χ test, and multiple logistic regression analysis were used for statistics.
Out of 348 eligible patients, 346 were included at the medical clinic (n = 170) and surgery clinic (n = 176). UWL occurred in 26%, with a mean weight loss of 7.1 kg (standard deviation [SD] 5.2), and 24% had RFI. A significantly increased risk of UWL was identified in patients with body mass index <18.5 kg/m (odds ratio 6.1; confidence interval 2.0-18.7; P = 0.003). NIS were more common in the medical clinic. The main self-reported reasons for NIS affecting UWL were lack of appetite (15% versus 12%), pain (14% versus 8%), and nausea (12% versus 3%).
One in four outpatients experienced UWL to an extent that may have a significant negative impact on clinical outcome. A firm correlation was found between UWL and RFI. Thus, based on this superficial study, UWL may be used as initial screening for protein-energy malnutrition in the medical and surgery gastroenterology outpatient setting. The impact on clinical outcome and of early nutritional intervention in these settings need to be investigated.
众所周知，住院患者的疾病相关营养不良（DRM）对临床结局有重大负面影响。同时，对胃肠病门诊患者的 DRM 研究甚少。本研究旨在调查非故意体重减轻（UWL）和食物摄入减少（RFI）作为导致门诊患者 DRM 风险的因素的患病率。此外，还旨在调查 UWL 是否可作为 DRM 的初步筛查方法，依据是 UWL 与 RFI 之间的相关性。
邀请 2018 年 9 月在丹麦奥尔堡大学医院医学和外科胃肠病科就诊的所有门诊患者参加此项基于问卷调查的横断面研究。本研究收集了过去 3 个月内 UWL、过去一周内 RFI 和营养影响症状（NIS）的数据。采用描述性分析、卡方检验和多因素逻辑回归分析进行统计学分析。
在 348 名符合条件的患者中，有 346 名患者纳入了内科（n=170）和外科门诊（n=176）。26%的患者发生 UWL，平均体重减轻 7.1kg（标准差 [SD] 5.2），24%的患者存在 RFI。BMI<18.5kg/m2 的患者 UWL 风险显著增加（比值比 6.1；95%置信区间 2.0-18.7；P=0.003）。内科门诊中 NIS 更为常见。导致 UWL 的主要自我报告原因是缺乏食欲（15%比 12%）、疼痛（14%比 8%）和恶心（12%比 3%）。
四分之一的门诊患者经历了一定程度的 UWL，这可能对临床结局产生重大负面影响。UWL 和 RFI 之间存在明确的相关性。因此，基于这项初步研究，UWL 可作为医学和外科胃肠病门诊患者蛋白质-能量营养不良的初步筛查方法。需要调查这些情况下 UWL 对临床结局的影响以及早期营养干预的效果。
