Cardenas Diana, Bermúdez Charles, Pérez Angélica, Diaz Gustavo, Cortés Lilia Yadira, Contreras Claudia Patricia, Pinzón-Espitia Olga Lucía, Gómez Gabriel, González Maria Cristina, Fantin Romain, Gutierrez José, Sulz Isabella, Tarantino Silvia, Hiesmayr Michael
Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogota, Colombia.
Surgery Department, Clínica La Colina and Clínica del Country, Bogota, Colombia.
JPEN J Parenter Enteral Nutr. 2022 Jan;46(1):83-92. doi: 10.1002/jpen.2085. Epub 2021 Mar 10.
Monitoring of adequate food intake is not a priority in hospital patients' care. The present study aimed to examine selective data from the nutritionDay survey to determine the impact of food intake during hospitalization on outcomes according to the nutrition risk status.
We conducted a descriptive analysis of selected data from 7 consecutive, annual, and cross-sectional nutritionDay samples from 2009 to 2015. The impact of food intake on outcomes was assessed by univariate and multivariate Cox models controlling for PANDORA scores.
A total of 7994 adult patients from Colombia, 7243 patients from 9 Latin American countries, and 155,524 patients worldwid were included. Less than half of the patients worldwide consumed their entire meal on nutritionDay (41%). The number of reduced eaters is larger in the "no nutrition risk group" than in the "nutrition risk group" (30% vs 25%). Reduced eating is associated with higher mortality and delayed discharge in patients, regardless of the nutrition risk status. Patients without nutrition risk at the screening who ate "nothing, but were allowed to eat" had 6 times more risk of mortality (hazard ratio, 6.48; 95% CI, 3.5311.87).
This is the first large-scale study evaluating the relationship of food intake on clinical outcomes showing an increase of in-hospital mortality rates and a reduction in the probability of being discharged home regardless of the nutrition risk status. Traditional screening tools may not identify a group of patients who will become at risk because of reduced intake while in the hospital.
在医院患者护理中，监测充足的食物摄入量并非优先事项。本研究旨在审查营养日调查的选择性数据，以根据营养风险状况确定住院期间食物摄入量对结局的影响。
我们对2009年至2015年连续7年的年度横断面营养日样本中的选定数据进行了描述性分析。通过控制潘多拉评分的单变量和多变量Cox模型评估食物摄入量对结局的影响。
共纳入了来自哥伦比亚的7994名成年患者、来自9个拉丁美洲国家的7243名患者以及全球155524名患者。全球范围内不到一半的患者在营养日吃完了整餐（41%）。“无营养风险组”中进食减少者的数量多于“营养风险组”（30%对25%）。无论营养风险状况如何，进食减少都与患者较高的死亡率和出院延迟相关。筛查时无营养风险但“未进食但被允许进食”的患者死亡风险高出6倍（风险比，6.48；95%置信区间，3.53至11.87）。
这是第一项评估食物摄入量与临床结局关系的大规模研究，结果显示无论营养风险状况如何，住院死亡率都会增加，出院回家的概率会降低。传统筛查工具可能无法识别出因住院期间摄入量减少而面临风险的一组患者。
