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营养风险筛查 2002 及微型营养评估简表对中国住院老年患者死亡率的预测价值。

Predictive Value of Nutritional Risk Screening 2002 and Mini Nutritional Assessment Short Form in Mortality in Chinese Hospitalized Geriatric Patients.

机构信息

Department of Geriatrics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, People's Republic of China.

出版信息

Clin Interv Aging. 2020 Mar 20;15:441-449. doi: 10.2147/CIA.S244910. eCollection 2020.

Abstract

BACKGROUND AND AIM

The presence of malnutrition in hospitalized geriatric patients is associated with an increased risk of mortality. This study aimed to examine the performance of Nutritional Risk Screening 2002 (NRS2002) and Mini Nutritional Assessment Short Form (MNA-SF) in predicting mortality for hospitalized geriatric patients in China.

METHODS

A prospective analysis was performed in 536 hospitalized geriatric patients aged ≥65 years. Nutrition status was assessed using the MNA-SF and NRS2002 scales within 24 hrs of admission. Anthropometric measures and biochemical parameters were carried out for each patient. Patients were follow-up for up to 2.5 years.

RESULTS

At baseline, 161 (30.04%) patients had malnutrition/nutritional risk according to NRS2002 assessment. According to MNA-SF, 284 (52.99%) patients had malnutrition/nutritional risk. Malnutrition/nutritional risk patients had lower anthropometric and biochemical parameters (<0.05). NRS2002 and MNA-SF had a strong correlation with classical nutritional markers (<0.05). NRS2002 versus MNA-SF showed moderate agreement (kappa=0.493, <0.001). During a median follow-up time of 795 days (range 10-947 days), 118 (22%) participants died. The Kaplan-Meier curve demonstrated that malnutrition/nutritional risk patients according to NRS2002 or MNA-SF assessment had a higher risk of mortality than the normal nutrition patients ( =17.67, <0.001; =28.999, <0.001, respectively). From the components of the Cox regression multivariate models, only the NRS2002 score was an independent risk factor influencing the mortality.

CONCLUSION

Both NRS2002 and MNA-SF scores could predict mortality in Chinese hospitalized geriatric patients. But only NRS2002 score was the independent predictor for mortality.

摘要

背景与目的

住院老年患者存在营养不良与死亡率增加相关。本研究旨在探讨营养风险筛查 2002(NRS2002)和微型营养评估简表(MNA-SF)在中国住院老年患者中预测死亡率的表现。

方法

对 536 名年龄≥65 岁的住院老年患者进行前瞻性分析。入院后 24 小时内使用 MNA-SF 和 NRS2002 量表评估营养状况。对每位患者进行人体测量和生化参数检查。对患者进行长达 2.5 年的随访。

结果

基线时,根据 NRS2002 评估,161 例(30.04%)患者存在营养不良/营养风险。根据 MNA-SF,284 例(52.99%)患者存在营养不良/营养风险。营养不良/营养风险患者的人体测量和生化参数较低(<0.05)。NRS2002 和 MNA-SF 与经典营养标志物具有很强的相关性(<0.05)。NRS2002 与 MNA-SF 显示中度一致性(kappa=0.493,<0.001)。在中位随访时间为 795 天(范围 10-947 天)期间,118 例(22%)参与者死亡。Kaplan-Meier 曲线表明,根据 NRS2002 或 MNA-SF 评估存在营养不良/营养风险的患者比正常营养患者的死亡风险更高(=17.67,<0.001;=28.999,<0.001)。在 Cox 回归多变量模型的组成部分中,只有 NRS2002 评分是影响死亡率的独立危险因素。

结论

NRS2002 和 MNA-SF 评分均能预测中国住院老年患者的死亡率。但只有 NRS2002 评分是死亡率的独立预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc6a/7093094/6c494b2630fd/CIA-15-441-g0001.jpg

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