Harris Ché Matthew, Wright Scott Mitchell
Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
JPEN J Parenter Enteral Nutr. 2021 Nov;45(8):1749-1754. doi: 10.1002/jpen.2067. Epub 2021 Mar 26.
Malnutrition among hospitalized adults with cerebral palsy (CP) has not been extensively explored. We sought to identify impacts of malnutrition on clinical and resource outcomes among hospitalized adults with CP.
This retrospective cohort study surveyed years 2016 and 2017 from the National Inpatient Sample database. Regression models evaluated mortality and resource utilization.
154,219 adults with CP were hospitalized. Among them, 21,064/154,219 (13.5%) had malnutrition. Patients with and without malnutrition were similar in age (mean age ± SEM, 45.1 ± 0.30 vs 45.2 ± 0.18 years; P = .70). Patients with malnutrition were more likely male (12,175/21,604 [57.8%] vs 72,929/133,155 [54.8%], P < .01) and had higher comorbidity scores (Charlson comorbidity score ≥ 3; 2,464/21,064 [11.7%] vs 14,380/133,155 [10.8%]; P = .01). Mortality rates were higher among patients with malnutrition (905/21,064 [4.3%] vs 2,796/21,064 [2.1%], P < .01), and they had higher odds for mortality (adjusted odds ratio [aOR] = 2.1; CI, 1.7-2.5; P < .01). Those with malnutrition were less likely discharged home (aOR = 0.52; CI, 0.48-0.56; P < .01). Hospital charges were higher (adjusted mean difference [aMD] = +$42,540; CI, $36,934-48,146; P < .01) and length of stay longer (aMD = +4.3 days; CI, 3.9-4.7; P < .01) among patients with malnutrition.
Malnutrition in hospitalized patients with CP is associated with increased mortality and hospital resource utilization. Flagging these patients as being "high risk" when they are hospitalized may result in heightened attentiveness about clinical outcomes in this vulnerable population.
住院的成年脑瘫(CP)患者中的营养不良情况尚未得到广泛研究。我们试图确定营养不良对住院成年CP患者临床和资源利用结果的影响。
这项回顾性队列研究调查了2016年和2017年国家住院样本数据库中的数据。回归模型评估了死亡率和资源利用情况。
154,219名成年CP患者住院治疗。其中,21,064/154,219(13.5%)患有营养不良。有和没有营养不良的患者年龄相似(平均年龄±标准误,45.1±0.30岁对45.2±0.18岁;P = 0.70)。营养不良的患者男性比例更高(12,175/21,604 [57.8%]对72,929/133,155 [54.8%],P < 0.01),且合并症评分更高(Charlson合并症评分≥3;2,464/21,064 [11.7%]对14,380/133,155 [10.8%];P = 0.01)。营养不良患者的死亡率更高(905/21,064 [4.3%]对2,796/21,064 [2.1%],P < 0.01),且死亡几率更高(调整后的优势比[aOR] = 2.1;置信区间[CI],1.7 - 2.5;P < 0.01)。营养不良的患者出院回家的可能性较小(aOR = 0.52;CI,0.48 - 0.56;P < 0.01)。营养不良患者的住院费用更高(调整后的平均差异[aMD] = +42,540美元;CI,36,934 - 48,146美元;P < 0.01),住院时间更长(aMD = +4.3天;CI,3.9 - 4.7;P < 0.01)。
住院CP患者的营养不良与死亡率增加和医院资源利用增加有关。在这些患者住院时将其标记为“高危”可能会提高对这一弱势群体临床结果的关注度。