Ohta Ryuichi, Ryu Yoshinori, Sano Chiaki
Community Care, Unnan City Hospital, 699-1221 96-1 Iida, Daito-cho, Unnan 699-1221, Shimane Prefecture, Japan.
Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo 693-8501, Shimane Prefecture, Japan.
Healthcare (Basel). 2021 Nov 23;9(12):1611. doi: 10.3390/healthcare9121611.
White nails are a sign of various physical deteriorations, including poor nutrition, organ damage, and aging. During a physical examination, white nails can be a helpful health indicator in older patients with vague and multiple symptoms. In this prospective cohort study of patients admitted to the Department of General Medicine in a rural community hospital, we investigated the relationship between white nails and patient mortality. Patient data, including age, sex, condition, and bloodwork results, were collected. Trained family physicians confirmed the presence of white nails. Logistic regression analysis was performed to determine the relationship between white nails and death during hospitalization. Of 711 study participants, 74 died during hospitalization. White nails, male sex, and caregiver dependence were associated with high in-hospital mortality (odds ratio (OR) = 3.47, < 0.001; OR 2.05, = 0.01; OR 1.92, = 0.049, respectively). High albumin concentration was associated with low in-hospital mortality (OR = 0.44, < 0.001). White nails, along with serum albumin concentration, male sex, and caregiver dependence, are associated with mortality. The identification of white nails can predict the deterioration of patients. Various professionals should learn to identify the presence of white nails to facilitate the care of elderly patients.
白甲是多种身体机能衰退的迹象，包括营养不良、器官损伤和衰老。在体格检查中，对于症状模糊且多样的老年患者，白甲可能是一个有用的健康指标。在这项针对一家农村社区医院普通内科收治患者的前瞻性队列研究中，我们调查了白甲与患者死亡率之间的关系。收集了患者的数据，包括年龄、性别、病情和血液检查结果。经过培训的家庭医生确认白甲的存在。进行逻辑回归分析以确定白甲与住院期间死亡之间的关系。在711名研究参与者中，74人在住院期间死亡。白甲、男性性别和对护理人员的依赖与高住院死亡率相关（比值比（OR）分别为3.47，P<0.001；OR 2.05，P = 0.01；OR 1.92，P = 0.049）。高白蛋白浓度与低住院死亡率相关（OR = 0.44，P<0.001）。白甲以及血清白蛋白浓度、男性性别和对护理人员的依赖与死亡率相关。白甲的识别可以预测患者的病情恶化。各类专业人员应学会识别白甲的存在，以方便对老年患者的护理。
