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30天内再次入院的临床和营养预测因素。

Clinical and nutritional predictors of hospital readmission within 30 days.

作者信息

Cruz Paula Luiza Menezes, Soares Bruna Lúcia de Mendonça, da Silva Jacqueline Elineuza, Lima E Silva Renata Reis de

机构信息

Posgraduate Program in Clinical Nutrition - Institute of Biological Sciences/University of Pernambuco, Recife-PE, Brazil.

Posgraduate Program in Nutrition - Federal University of Pernambuco, Recife-PE, Brazil.

出版信息

Eur J Clin Nutr. 2022 Feb;76(2):244-250. doi: 10.1038/s41430-021-00937-y. Epub 2021 May 26.

Abstract

BACKGROUND/OBJECTIVES: Identify clinical, sociodemographic, and nutritional predictors of hospital readmission within 30 days.

SUBJECTS/METHODS: A longitudinal study was conducted with patients hospitalised at a public institution in Recife, Brazil. Sociodemographic (age, sex, race, and place of residence), clinical (diagnosis, comorbidities, medications, polypharmacy, hospital outcome, hospital stay, and occurrence of readmission within 30 days), and nutritional (% of weight loss, body mass index, arm circumference [AC], and calf circumference [CC]) characteristics were collected from the nutritional assessment files and patient charts. Nutritional risk was determined using the 2002 Nutritional Risk Screening tool and the diagnosis of malnutrition was based on the GLIM criteria.

RESULTS

The sample was composed of 252 patients, 58 (23.0%; CI: 17.2-28.8%) of whom were readmitted within 30 days after discharge from hospital, 135 (53.5%; CI: 46.7-60.5%) were at nutritional risk and 107 (42.4%; CI: 35.6-49.3%) were malnourished. In the bivariate analysis, polypharmacy, nutritional risk, malnutrition, low AC, and low CC were associated with readmission. In the multivariate analysis, low CC was considered an independent risk factor, increasing the likelihood of hospital readmission nearly fourfold. In contrast, the absence of polypharmacy was a protective favour, reducing the likelihood of readmission by 81%.

CONCLUSIONS

The use of six medications or more and low calf circumference are risk factors for hospital readmission within 30 days after discharge.

摘要

背景/目的:确定30天内再次入院的临床、社会人口学和营养预测因素。

受试者/方法:对巴西累西腓一家公共机构收治的患者进行了一项纵向研究。从营养评估文件和患者病历中收集社会人口学特征(年龄、性别、种族和居住地点)、临床特征(诊断、合并症、用药情况、多重用药、住院结局、住院时间和30天内再次入院情况)以及营养特征(体重减轻百分比、体重指数、上臂围[AC]和小腿围[CC])。使用2002年营养风险筛查工具确定营养风险,营养不良的诊断基于GLIM标准。

结果

样本包括252名患者,其中58名(23.0%;置信区间:17.2 - 28.8%)在出院后30天内再次入院,135名(53.5%;置信区间:46.7 - 60.5%)存在营养风险,107名(42.4%;置信区间:35.6 - 49.3%)营养不良。在双变量分析中,多重用药、营养风险、营养不良、低AC和低CC与再次入院相关。在多变量分析中,低CC被认为是一个独立的风险因素,使再次入院的可能性增加近四倍。相比之下,不存在多重用药是一个保护因素,使再次入院的可能性降低81%。

结论

使用六种或更多药物以及小腿围较低是出院后30天内再次入院的风险因素。

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