University Department of Medicine, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland.
Department of Medicine, and Institute of Human Nutrition, Columbia University Irving Medical Center, New York, NY, USA.
Lancet. 2021 Nov 20;398(10314):1927-1938. doi: 10.1016/S0140-6736(21)01451-3. Epub 2021 Oct 14.
Disease-related malnutrition in adult patients who have been admitted to hospital is a syndrome associated with substantially increased morbidity, disability, short-term and long-term mortality, impaired recovery from illness, and cost of care. There is uncertainty regarding optimal diagnostic criteria, definitions for malnutrition, and how to identify patients who would benefit from nutritional intervention. Malnutrition has become the focus of research aimed at translating current knowledge of its pathophysiology into improved diagnosis and treatment. Researchers are particularly interested in developing nutritional interventions that reverse the negative effects of disease-related malnutrition in the hospital setting. High-quality randomised trials have provided evidence that nutritional therapy can reduce morbidity and other complications associated with malnutrition in some patients. Screening of patients for risk of malnutrition at hospital admission, followed by nutritional assessment and individualised nutritional interventions for malnourished patients, should become part of routine clinical care and multimodal treatment in hospitals worldwide.
成人住院患者的疾病相关营养不良是一种综合征,与发病率显著增加、残疾、短期和长期死亡率增加、疾病康复受损以及医疗费用增加有关。关于最佳诊断标准、营养不良的定义以及如何确定哪些患者受益于营养干预,存在不确定性。营养不良已成为研究的焦点,旨在将其病理生理学的现有知识转化为改善诊断和治疗。研究人员特别感兴趣的是开发营养干预措施,以逆转医院环境中与疾病相关的营养不良的负面影响。高质量的随机试验提供了证据,表明营养疗法可以减少某些患者与营养不良相关的发病率和其他并发症。在医院入院时对患者进行营养不良风险筛查,然后对营养不良患者进行营养评估和个体化营养干预,应成为全球医院常规临床护理和多模式治疗的一部分。