Purnamasari Dyah, Bunawan Nur Chandra, Suseno Dwi, Rinaldi Ikhwan, Dillon Drupadi Hs
Endocrinology Metabolism and Diabetes Division, Internal Medicine Department, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Internal Medicine Department, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Nutr Res Pract. 2023 Apr;17(2):218-227. doi: 10.4162/nrp.2023.17.2.218. Epub 2022 Aug 3.
BACKGROUND/OBJECTIVES: Malnutrition during hospitalization is linked to increased morbidity and mortality, but there are insufficient studies observing clinical factors contributing to weight loss during hospitalization in Indonesia. This study was therefore undertaken to determine the rate of weight loss during hospitalization and the contributing factors.
SUBJECTS/METHODS: This was a prospective study involving hospitalized adult patients aged 18-59 yrs, conducted between July and September 2019. Body weight measurement was taken at the time of admission and on the last day of hospitalization. The factors studied were malnutrition at admission (body mass index < 18.5 kg/m), immobilization, depression (Beck Depression Inventory-II Indonesia), polypharmacy, inflammatory status (neutrophil-lymphocytes ratio; NLR), comorbidity status (Charlson Comorbidity Index; CCI), and length of stay.
Totally, 55 patients were included in the final analysis, with a median age of 39 (18-59 yrs) yrs. Of these, 27% had malnutrition at admission, 31% had a CCI score > 2, and 26% had an NLR value of ≥ 9. In all, 62% presented with gastrointestinal symptoms, and depression was documented in one-third of the subjects at admission. Overall, we recorded a mean weight loss of 0.41 kg ( = 0.038) during hospitalization, with significant weight loss observed among patients hospitalized for 7 days or more ( = 0.009). The bivariate analysis revealed that inflammatory status ( = 0.016) was associated with in-hospital weight loss, while the multivariate analysis determined that the contributing factors were length of stay ( < 0.001) and depression ( = 0.019).
We found that inflammatory status of the patient might influence the incidence of weight loss during hospitalization, while depression and length of stay were independent predictors of weight loss during hospitalization.
背景/目的：住院期间的营养不良与发病率和死亡率增加有关，但在印度尼西亚，观察导致住院期间体重减轻的临床因素的研究不足。因此，本研究旨在确定住院期间的体重减轻率及其影响因素。
受试者/方法：这是一项前瞻性研究，纳入了2019年7月至9月期间住院的18 - 59岁成年患者。在入院时和住院的最后一天测量体重。研究的因素包括入院时的营养不良（体重指数<18.5 kg/m²）、活动受限、抑郁（贝克抑郁量表 - II印尼版）、多种药物治疗、炎症状态（中性粒细胞与淋巴细胞比值；NLR）、合并症状态（查尔森合并症指数；CCI）以及住院时间。
最终纳入55例患者进行分析，中位年龄为39岁（18 - 59岁）。其中，27%的患者入院时存在营养不良，31%的患者CCI评分>2，26%的患者NLR值≥9。总体而言，62%的患者出现胃肠道症状，三分之一的受试者在入院时记录有抑郁症状。总体而言，我们记录到住院期间平均体重减轻0.41 kg（标准差 = 0.038），住院7天或更长时间的患者体重显著减轻（P = 0.009）。双变量分析显示炎症状态（P = 0.016）与住院期间体重减轻有关，而多变量分析确定影响因素为住院时间（P < 0.001）和抑郁（P = 0.019）。
我们发现患者的炎症状态可能影响住院期间体重减轻的发生率，而抑郁和住院时间是住院期间体重减轻的独立预测因素。
