Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Herne, Germany.
Department of Geriatrics, Bethesda Krankenhaus Bergedorf, Hamburg, Germany.
Clin Interv Aging. 2020 Nov 19;15:2219-2226. doi: 10.2147/CIA.S278578. eCollection 2020.
BACKGROUND: Studies focusing on self-perception of nutritional status in older hospitalized patients are lacking. We aimed to examine the self-perception of body weight and nutritional status among older hospitalized patients compared to their actual body weight and nutritional status based on medical assessment. MATERIALS AND METHODS: This observational cross-sectional study investigated 197 older participants (mean age 82.2±6.8 years, 61% women) who were consecutively admitted to the geriatric acute care ward. Body weight status and nutritional status were assessed using WHO-BMI classification and Mini Nutritional Assessment-Short Form (MNA-SF), respectively. Self-perceived body weight status and nutritional status were assessed with a standardized questionnaire. A follow-up was performed with a short telephone interview after three months. RESULTS: According to MNA-SF, 49% and 35% were at risk of malnutrition and malnourished, respectively. There was no agreement between self-perceived nutritional status and objective nutritional status according to MNA-SF (Kappa: 0.06). A slight agreement was found between subjective body weight status and objective body weight status according to WHO-BMI classification (Kappa: 0.19). A total of 184 patients completed the 3 months follow-up and additional 9 patients died during this time, of which 7 and 2 were malnourished and at risk of malnutrition according to MNA-SF, respectively. Of those who were malnourished and at risk of malnutrition based on MNA-SF and died during follow-up, 67.7% did not realize their malnutrition. Compared to the patients with normal nutritional status during hospitalization, malnourished patients based on MNA-SF had higher rates of unplanned hospital readmission and further weight loss and more often reported health deterioration and experienced death within three months after discharge. CONCLUSION: No agreement between self-perceived nutritional status and objective nutritional status among older hospitalized patients was found. Our study highlights the need to raise knowledge about the issue of malnutrition and increase awareness of health risks associated with malnutrition among older hospitalized patients.
背景：缺乏针对老年住院患者自我营养状况感知的研究。我们旨在根据医学评估，比较老年住院患者自我感知的体重和营养状况与实际体重和营养状况。
材料与方法：本观察性横断面研究纳入了 197 名年龄在 82.2±6.8 岁的老年患者（61%为女性），他们连续入住老年急性护理病房。使用世界卫生组织（WHO）BMI 分类和迷你营养评估-短表（MNA-SF）评估体重状况和营养状况。使用标准化问卷评估自我感知的体重和营养状况。三个月后进行简短的电话随访。
结果：根据 MNA-SF，49%和 35%的患者有营养不良和营养不足的风险。根据 MNA-SF，自我感知的营养状况与客观营养状况之间没有一致性（Kappa：0.06）。根据 WHO-BMI 分类，主观体重状况与客观体重状况之间存在轻微的一致性（Kappa：0.19）。共有 184 名患者完成了 3 个月的随访，在此期间又有 9 名患者死亡，其中 7 名和 2 名根据 MNA-SF 被诊断为营养不良和有营养不良风险。在基于 MNA-SF 被诊断为营养不良和有营养不良风险并在随访期间死亡的患者中，67.7%的患者没有意识到自己的营养不良。与住院期间营养状况正常的患者相比，基于 MNA-SF 被诊断为营养不良的患者出院后计划外再住院率更高，体重进一步下降，更多地报告健康恶化，并在出院后三个月内死亡。
结论：老年住院患者自我感知的营养状况与客观营养状况之间没有一致性。我们的研究强调了提高对营养不良问题的认识并增强老年住院患者对与营养不良相关的健康风险的认识的必要性。
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