Nutrition Support Team, Seoul National University Hospital, Seoul, Korea.
Department of Nursing, Seoul National University Hospital, Seoul, Korea.
JPEN J Parenter Enteral Nutr. 2021 Feb;45(2):357-365. doi: 10.1002/jpen.1835. Epub 2020 May 20.
The aim of this study was to investigate the nutrition support team (NST) reconsultation practice and to evaluate reasons and describe risk factors for NST reconsultation during nutrition therapy (NT) in hospitalized patients.
This study included 2505 patients aged >18 years who received NT through NST consultation between January 2016 and December 2016 at Seoul National University Hospital. NST reconsultation refers to consulting the NST more than twice during a single hospitalization period. Risk factors affecting NST reconsultation were included only when NST reconsultation occurred for specific reasons other than routine evaluations.
The NST reconsultation rate was 36.4% (913/2505) with 926 reasons, including 'changes in the nutrition provision method' (n = 474, 51.2%), 'NT-related complications' (n = 284, 30.7%), 'routine evaluations' (n = 137, 14.8%), and 'discharge planing including home NT' (n = 31, 3.3%). The reconsultation rate of enteral nutrition (EN) was 40.8% (n = 378) and that of parenteral nutrition (PN) was 59.2% (n = 548). Among the NT-related complications, diarrhea (n = 65, 49.2%) was the most common with EN, whereas electrolyte abnormality (n = 52, 34.2%) was the most common with PN. Performance of surgery (odds ratio [OR], 2.061; P < .001), low serum albumin levels (<3 mg/dL; OR, 1.672; P < .001), presence of comorbidities (OR, 1.556; P < .001), and low body mass index (kg/m ) (<18.5; OR, 1.508; P < .001) were predictive risk factors for NST reconsultation.
Frequent evaluation of nutrition status through a multidisciplinary NST is important in patients with these risk factors.
本研究旨在调查营养支持小组（NST）的再咨询实践，并评估在住院患者的营养治疗（NT）期间，NST 再咨询的原因和描述其风险因素。
本研究纳入了 2016 年 1 月至 12 月期间在首尔国立大学医院接受 NST 咨询的 2505 名年龄>18 岁的患者。NST 再咨询是指在单次住院期间向 NST 咨询两次以上。仅当 NST 再咨询是出于常规评估以外的特定原因时，才纳入影响 NST 再咨询的风险因素。
NST 再咨询率为 36.4%（913/2505），共 926 次咨询，原因包括“营养供给方式改变”（n=474，51.2%）、“与 NT 相关的并发症”（n=284，30.7%）、“常规评估”（n=137，14.8%）和“包括家庭 NT 的出院计划”（n=31，3.3%）。肠内营养（EN）的再咨询率为 40.8%（n=378），肠外营养（PN）的再咨询率为 59.2%（n=548）。在与 NT 相关的并发症中，EN 最常见的是腹泻（n=65，49.2%），而 PN 最常见的是电解质异常（n=52，34.2%）。手术（比值比[OR]，2.061；P<.001）、低血清白蛋白水平（<3mg/dL；OR，1.672；P<.001）、合并症（OR，1.556；P<.001）和低 BMI（kg/m ）（<18.5；OR，1.508；P<.001）是 NST 再咨询的预测风险因素。
对于具有这些风险因素的患者，通过多学科 NST 频繁评估营养状况非常重要。
