Eraslan Doganay Guler, Ulger Gulay
Anesthesiology and Reanimation Clinic, Health Sciences University Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, TUR.
Cureus. 2022 Jan 25;14(1):e21579. doi: 10.7759/cureus.21579. eCollection 2022 Jan.
Background Malnutrition is a change in body composition as a result of inadequate nutrient intake or malabsorption. It has a significant effect on morbidity and mortality as a result of increased catabolism in acute and/or chronic diseases of many systems or organs. This study was conducted in a chest diseases branch hospital; applicants to the nutritional clinic are mostly patients with acute or chronic respiratory failure. This study aimed to evaluate the nutritional status of patients at the time of admission to the nutritional clinic and the relationship between nutritional support treatment and mortality. Materials and methods The data of 750 patients who applied to the nutritional clinic and consulted clinics, services, and intensive care units were retrospectively analyzed. The patients' demographic data, diagnoses, body mass indexes (BMI), Nutritional Risk Screening (NRS-2002) scores were determined to evaluate malnutrition risks, nutritional support treatments were recorded as enteral, total parenteral, oral enteral supplementation, and nutritional follow-up was initiated. The patients' main diagnoses were the cause of malnutrition, which were divided into five groups: tuberculosis, chronic obstructive pulmonary disease (COPD), malignancy, neurological diseases, and interstitial lung disease. Thirty-dayand 90-day mortality data were recorded. Results A total of 737 patients were included in the study. Of them, 478 (64.8%) were in the geriatric age group. There were 662 (89.9%) patients with an NRS score of ≥3 who were evaluated as malnourished. Enteral nutrition is higher in patients with neurological disease and interstitial lung disease as compared to other diseases. Oral enteral supplementation (OES) is lower in patients with neurological disease and interstitial lung disease compared to other diseases. The rate of nutritional follow-up is higher in patients with interstitial lung disease than in other diseases. The ages and NRS scores of those with mortality were statistically significantly higher than those without mortality. According to the main diagnoses, the rate of COPD patients is significantly lower and the rate of malignant patients significantly higher in patients. The increase in BMI and NRS-2002 score of 3 and above were risk factors for 30-day mortality. OES was the most recommended nutritional product in patients with or without 30-day and 90-day mortality. Conclusion Eighty-nine point nine percent (89.9%) of the patients were evaluated as malnourished, and OES was the most recommended nutritional supplement in all patient groups. Mortality was higher in the malignant group and lower in the COPD group as compared to others. There was no correlation between the nutritional product and mortality.
背景 营养不良是由于营养摄入不足或吸收不良导致的身体成分变化。在许多系统或器官的急慢性疾病中，由于分解代谢增加，营养不良对发病率和死亡率有重大影响。本研究在一家胸科疾病分院进行；营养门诊的就诊者大多是急性或慢性呼吸衰竭患者。本研究旨在评估患者入住营养门诊时的营养状况以及营养支持治疗与死亡率之间的关系。
材料与方法 对750名申请营养门诊并咨询门诊、服务部门和重症监护病房的患者数据进行回顾性分析。确定患者的人口统计学数据、诊断、体重指数（BMI）、营养风险筛查（NRS-2002）评分以评估营养不良风险，记录营养支持治疗方式为肠内营养、全胃肠外营养、口服肠内补充营养，并开始营养随访。患者的主要诊断为营养不良的原因，分为五组：结核病、慢性阻塞性肺疾病（COPD）、恶性肿瘤、神经系统疾病和间质性肺疾病。记录30天和90天的死亡率数据。
结果 本研究共纳入737例患者。其中，478例（64.8%）为老年年龄组。NRS评分≥3分的患者有662例（89.9%）被评估为营养不良。与其他疾病相比，神经系统疾病和间质性肺疾病患者的肠内营养比例更高。与其他疾病相比，神经系统疾病和间质性肺疾病患者的口服肠内补充营养（OES）比例更低。间质性肺疾病患者的营养随访率高于其他疾病。死亡患者的年龄和NRS评分在统计学上显著高于未死亡患者。根据主要诊断，患者中COPD患者的比例显著较低，恶性肿瘤患者的比例显著较高。BMI增加以及NRS-2002评分达到3分及以上是30天死亡率的危险因素。在有或没有30天和90天死亡率的患者中，OES是最常推荐的营养产品。
结论 89.9%的患者被评估为营养不良，OES是所有患者组中最常推荐的营养补充剂。与其他组相比，恶性肿瘤组的死亡率较高，COPD组的死亡率较低。营养产品与死亡率之间无相关性。
