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心房颤动患者营养状况与住院时间的关系——营养状况心脏研究的结果

Relationship between nutritional status and length of hospital stay among patients with atrial fibrillation - a result of the nutritional status heart study.

作者信息

Czapla Michał, Uchmanowicz Izabella, Juárez-Vela Raúl, Durante Angela, Kałużna-Oleksy Marta, Łokieć Katarzyna, Baeza-Trinidad Ramón, Smereka Jacek

机构信息

Department of Emergency Medical Service, Wroclaw Medical University, Wrocław, Poland.

Institute of Heart Diseases, University Hospital, Wrocław, Poland.

出版信息

Front Nutr. 2022 Dec 14;9:1086715. doi: 10.3389/fnut.2022.1086715. eCollection 2022.

Abstract

BACKGROUND

Nutritional status is related to the prognosis and length of hospital stay (LOHS) of patients with atrial fibrillation (AF). This study aimed to assess how nutritional status affects LOHS for patients with AF.

METHODS

We performed retrospective analysis of the medical records of 1,813 patients admitted urgently with a diagnosis of AF to the Institute of Heart Diseases of the University Clinical Hospital in Wroclaw, Poland.

RESULTS

In total, 1,813 patients were included in the analysis. The average LOHS in the entire group was 3.53 ± 3.41 days. The mean BMI was 28.7 kg/m (SD: 5.02). Patients who were hospitalized longer were statistically more likely to have a Nutritional Risk Score (NRS) ≥3 ( = 0.028). A higher percentage of longer hospitalized patients with LDL levels below 70 mg/dl ( < 0.001) and those with HDL ≥40 mg/dl ( < 0.001) were observed. Study participants with NRS ≥3 were an older group ( = 76.3 years), with longer mean LOHS ( = 4.44 days). The predictors of LOHS in the univariate model were age (OR = 1.04), LDL (OR = 0.99), HDL (OR = 0.98), TC (OR = 0.996), CRP (OR = 1, 02, < 0.001), lymphocytes (OR = 0.97, = 0.008) and in the multivariate model were age, LDL (mg/dl), HDL (mg/dl), Na, and K.

CONCLUSION

For nutritional status, factors indicating the risk of prolonged hospitalization in patients with AF are malnutrition, lower serum LDL, HDL, potassium, and sodium levels identified at the time of admission to the cardiology department. Assessment of nutritional status in patients with AF is important both in the context of evaluating obesity and malnutrition status, as both conditions can alter the prognosis of patients. Further studies are needed to determine the exact impact of the above on the risk of prolonged hospitalization.

摘要

背景

营养状况与房颤(AF)患者的预后及住院时间(LOHS)相关。本研究旨在评估营养状况如何影响AF患者的LOHS。

方法

我们对波兰弗罗茨瓦夫大学临床医院心脏病研究所1813例因AF紧急入院的患者病历进行了回顾性分析。

结果

总计1813例患者纳入分析。整个组的平均LOHS为3.53±3.41天。平均BMI为28.7kg/m(标准差:5.02)。住院时间较长的患者在统计学上更有可能营养风险评分(NRS)≥3(P = 0.028)。观察到住院时间较长且低密度脂蛋白(LDL)水平低于70mg/dl的患者比例更高(P < 0.001),以及高密度脂蛋白(HDL)≥40mg/dl的患者比例更高(P < 0.001)。NRS≥3的研究参与者年龄更大(平均年龄 = 76.3岁),平均LOHS更长(平均 = 4.44天)。单因素模型中LOHS的预测因素为年龄(OR = 1.04)、LDL(OR = 0.99)、HDL(OR = 0.98)、总胆固醇(TC)(OR = 0.996)、C反应蛋白(CRP)(OR = 1.02,P < 0.001)、淋巴细胞(OR = 0.97,P = 0.008),多因素模型中的预测因素为年龄、LDL(mg/dl)、HDL(mg/dl)、钠和钾。

结论

就营养状况而言,AF患者住院时间延长风险的指示因素为营养不良、心内科入院时确定的较低血清LDL、HDL、钾和钠水平。评估AF患者的营养状况在评估肥胖和营养不良状态方面都很重要,因为这两种情况都可能改变患者的预后。需要进一步研究以确定上述因素对住院时间延长风险的确切影响。

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