12239Emory University School of Medicine, Atlanta, GA, USA.
Am Surg. 2022 Aug;88(8):2045-2049. doi: 10.1177/00031348221094217. Epub 2022 Apr 29.
Food insecurity (FI) has been defined as a lack of consistent access to enough food for a healthy active lifestyle. As of 12.7% of the United States are suffering from FI, which has been correlated with increased hospital costs and poorer health outcomes. Currently, limited data exists examining the relationship between trauma populations and FI despite both having similar root causes. We sought to determine this and validate a screening tool for FI in this population.
A cross-sectional survey study of trauma patients was conducted at a level 1 trauma center in Atlanta, Georgia. Survey questions included the first two items of the Core Food Security Module. Zip codes were used to determine FI, defined by the USDA Food Access Research and compared to individual participant survey responses. Binary classification test metrics were calculated to validate the two items as a screening tool in this population.
The cohort included 136 patients, of which the majority were black (60.3%) and male (60.3%). Thirty-one respondents affirmed food security (22.8%) despite over half (51.5%) living in a food insecure community. The sensitivity and specificity for this screening to predict FI were 25 and 80%, respectively.
Although the specificity is high, this screening tool has a low sensitivity, accuracy, NPV, and PPV to determine food insecurity in this population. Community-level statistics suggests that food insecurity is a significant public problem amongst trauma patients. Prevention efforts should, therefore, aim to address both issues simultaneously.
食品不安全（FI）被定义为缺乏持续获得健康积极生活所需足够食物的能力。目前，美国有 12.7%的人遭受食品不安全的困扰，这与医院成本增加和健康状况恶化有关。尽管创伤人群和食品不安全人群有相似的根本原因，但目前关于这两者之间关系的研究数据有限。我们试图确定这一点，并在这一人群中验证一种食品不安全筛查工具。
在佐治亚州亚特兰大的一家一级创伤中心进行了一项创伤患者的横断面调查研究。调查问题包括核心食品保障模块的前两个项目。邮政编码用于确定美国农业部（USDA）食品获取研究中定义的食品不安全，并将其与个别参与者的调查回复进行比较。计算了二项分类测试指标，以验证这两个项目作为该人群的筛查工具的有效性。
该队列包括 136 名患者，其中大多数是黑人（60.3%）和男性（60.3%）。尽管有一半以上（51.5%）的人生活在食品不安全的社区，但有 31 名受访者肯定了食品保障（22.8%）。该筛查工具预测食品不安全的敏感性和特异性分别为 25%和 80%。
尽管特异性较高，但该筛查工具在确定该人群的食品不安全方面具有较低的敏感性、准确性、阴性预测值和阳性预测值。社区层面的统计数据表明，食品不安全是创伤患者面临的一个重大公共问题。因此，预防工作应旨在同时解决这两个问题。
