Department of Thoracic surgery, Renmin Hospital of Wuhan University, Jiefang Road 238, Hubei province, Wuhan, 430060, PR China.
Department of General surgery, Renmin Hospital of Wuhan University, Jiefang Road 238, Hubei province, Wuhan, 430060, PR China.
Eur J Clin Nutr. 2020 Jun;74(6):876-883. doi: 10.1038/s41430-020-0659-7. Epub 2020 May 13.
The aim of this study was to assess the nutritional risks among older patients with COVID-19 and their associated clinical outcomes using four nutritional risk screening (NRS) tools: Nutrition Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), Mini Nutrition Assessment Shortcut (MNA-sf), and Nutrition Risk Index (NRI).
We retrospectively analyzed the data of patients with COVID-19 older than 65 years who were treated in our hospital from January 28, 2020 to March 5, 2020, and explored the relationship between nutritional risk and clinical outcomes.
A total of 141 patients with COVID-19 (46 common COVID-19, 73 severe COVID-19, and 22 extremely severe COVID-19) were enrolled in the study. NRS 2002 identified 85.8% of patients as having risk, with being identified 41.1% by MUST, 77.3% by MNA-sf, and 71.6% by NRI. The agreement strength was moderate between NRS 2002 and MNA-sf, NRI, fair between MUST and MNA-sf, NRI, fair between MNA-sf and NRI, poor between NRS 2002 and MUST (P < 0.01). After adjustment for confounding factors in multivariate regression analysis, patients in the risk group had significantly longer LOS, higher hospital expenses (except MNA-sf), poor appetite, heavier disease severity, and more weight change(kg) than normal patients by using NRS 2002, MNA-sf, and NRI(P < 0.05).
The NRS 2002, MNA-sf, and NRI are useful and practical tools with respect to screening for patients with COVID-19 who are at nutritional risk, as well as in need of additional nutritional intervention.
本研究旨在使用四种营养风险筛查(NRS)工具评估 COVID-19 老年患者的营养风险及其相关临床结局:营养风险筛查 2002(NRS 2002)、营养不良通用筛查工具(MUST)、微型营养评估简表(MNA-sf)和营养风险指数(NRI)。
我们回顾性分析了 2020 年 1 月 28 日至 2020 年 3 月 5 日在我院接受治疗的年龄大于 65 岁的 COVID-19 患者的数据,并探讨了营养风险与临床结局之间的关系。
共纳入 141 例 COVID-19 患者(普通型 COVID-19 46 例、重型 COVID-19 73 例、危重型 COVID-19 22 例)。NRS 2002 识别出 85.8%的患者存在风险,MUST 识别出 41.1%,MNA-sf 识别出 77.3%,NRI 识别出 71.6%。NRS 2002 与 MNA-sf、NRI 之间的一致性强度为中度,MUST 与 MNA-sf、NRI 之间的一致性强度为一般,MNA-sf 与 NRI 之间的一致性强度为一般,NRS 2002 与 MUST 之间的一致性强度为差(P<0.01)。多变量回归分析调整混杂因素后,NRS 2002、MNA-sf 和 NRI 风险组患者 LOS 较长,住院费用(MNA-sf 除外)较高,食欲较差,疾病严重程度较重,体重变化(kg)较大(P<0.05)。
NRS 2002、MNA-sf 和 NRI 是评估 COVID-19 患者营养风险和需要额外营养干预的有用和实用工具。