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重症监护患者的微型营养评定量表评分与感染之间的关系

Relationship between Mini Nutritional Assessment Score and Infection in Critical Care Patients.

作者信息

Moradi Moghaddam Omid, Niakan Lahiji Mohammad, Yazdan Panah Leyla, Talebi-Taher Mahshid, Rajabi Alireza, Mirhosseini Seyedeh Farnaz

机构信息

Trauma and Injury Research Center, Critical Care Department, Iran University of Medical Sciences, Tehran, Iran.

Department of Nutritional Sciences, School of Public Health, Hazrat-e Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Med J Islam Repub Iran. 2022 Aug 13;36:91. doi: 10.47176/mjiri.36.91. eCollection 2022.

Abstract

Nutrition and infectious diseases are 2 influential factors. Mini nutritional assessment (MNA) score is one of the indicators for assessing the nutritional status of the patients. The present study aimed to evaluate the relationship between MNA- short form (SF) and the infectious status of patients admitted to the intensive care unit (ICU) of Hazrat-e-Rasoul hospital in Tehran. This was a cross-sectional study performed at Hazrat-e-Rasoul hospital in Tehran from 2019 to 2020. Each patient completed the MNA-SF questionnaire. The questionnaire has 6 factors with a score range of 0 to 14, with 12 to 14 indicating "normal nutrition," 8 to 11 indicating "at risk of malnutrition," and 0 to 7 indicating "malnutrition." The patients were monitored for clinical and paraclinical signs and symptoms of infectious disease for the first 14 days after being admitted to the ICU. Then, the relationship between infection level and MNA-SF scores were recorded and the chi-square, independent samples t test, and Pearson correlation test were used. In this study, 119 patients (60 men and 59 women), with a mean age of 53.82 ± 19.76 years were selected, and 71 (59.67%) of the patients had an infection. Women without infection were significantly more than men (=0.021). In the assessment of the MNA-SF questionnaire, we found that 62 (52.1%) patients had "normal nutrition" status, 30 (25.2%), and 27 (22.7%) had "at risk for malnutrition" and "malnutrition" status, respectively. MNA-SF scores were significantly different in different age groups (=0.040). There was a significant relationship between weight loss, mobility, and neuropsychological problems with age (<0.001). Also, there was a meaningful relationship between nutritional status and infection (=0.032). The results determined that noninfected cases among the patients with "normal nutrition" status were more than those "at risk for malnutrition" (=0.007). The results of this study showed that clinical outcomes had a significant relationship with nutritional status (=0.043). Based on the present study, good nutritional status can reduce infection and mortality in patients who are admitted to ICU, and the nutritional status assessed with MNA-SF can play an essential role in patients' susceptibility to infection.

摘要

营养与感染性疾病是两个影响因素。微型营养评定(MNA)评分是评估患者营养状况的指标之一。本研究旨在评估MNA简表(SF)与德黑兰哈兹拉特 - 拉苏尔医院重症监护病房(ICU)收治患者的感染状况之间的关系。这是一项于2019年至2020年在德黑兰哈兹拉特 - 拉苏尔医院开展的横断面研究。每位患者均完成了MNA - SF问卷。该问卷有6个因素,评分范围为0至14分,12至14分表示“营养正常”,8至11分表示“有营养不良风险”,0至7分表示“营养不良”。患者在入住ICU后的前14天接受感染性疾病的临床和辅助检查体征及症状监测。然后,记录感染水平与MNA - SF评分之间的关系,并使用卡方检验、独立样本t检验和Pearson相关检验。在本研究中,选取了119例患者(60例男性和59例女性),平均年龄为53.82±19.76岁,其中71例(59.67%)患者发生了感染。未感染的女性明显多于男性(P = 0.021)。在MNA - SF问卷评估中,我们发现62例(52.1%)患者处于“营养正常”状态,30例(25.2%)和27例(22.7%)分别处于“有营养不良风险”和“营养不良”状态。不同年龄组的MNA - SF评分存在显著差异(P = 0.040)。体重减轻、活动能力和神经心理问题与年龄之间存在显著关系(P<0.001)。此外,营养状况与感染之间存在有意义的关系(P = 0.032)。结果表明,“营养正常”状态患者中的未感染病例多于“有营养不良风险”的患者(P = 0.007)。本研究结果表明临床结局与营养状况存在显著关系(P = 0.043)。基于本研究,良好的营养状况可降低入住ICU患者的感染率和死亡率,并且用MNA - SF评估的营养状况在患者对感染的易感性方面可发挥重要作用。

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