评价急性住院期间的食物摄入监测的流行情况及其与未考虑肠内或肠外营养的住院患者的营养不良筛查评分的关系。
Evaluation of prevalence of food intake monitoring during acute hospitalization and its association with malnutrition screening scores of inpatients who were not considered for enteral or parenteral nutrition.
机构信息
Department of Nursing, Rambam Health Care Campus, Haifa, Israel.
Institute of Gastroenterology, Rambam Health Care Campus, Haifa, Israel.
出版信息
Nutrition. 2023 Jun;110:112031. doi: 10.1016/j.nut.2023.112031. Epub 2023 Mar 11.
OBJECTIVES
Malnutrition risk can be recognized by nurses using screening tools and food intake monitoring. We measured the prevalence of food intake reporting and its association with malnutrition screening scores or other patient characteristics.
METHODS
This retrospective cohort study collected hospital database information regarding patients aged ≥18 y who were hospitalized for ≥ 7 consecutive days and were orally fed or had medical records that no tube feeding or parenteral nutrition had been administered. Data were collected and statistically analyzed focusing on food intake reporting, Malnutrition Universal Screening Tool (MUST) scores, oral nutritional intervention, and other secondary characteristics.
RESULTS
Out of 5155 patients admitted to two internal medicine departments over 1 y (July 1, 2018, through August 31, 2019), 1087 fulfilled the inclusion criteria with a mean age of 72.4 ± 14.6 y; of these, 74.6% had sufficient food intake reports. No food intake was reported for one-third of patients with MUST scores ≥ 2. There were no differences between the groups of patients with and without reported food intake with regard to MUST scores, sex, mean albumin level, comorbidity, length of stay, all-cause in-hospital mortality, hospital-acquired pressure injury, or the rate of oral nutritional intervention. MUST scores ≥ 2 were not significantly associated with intake reporting. Increased probability of having food intake reported was found in patients ages ≥70 y (adjusted odds ratio = 1.36; P = 0.036 [95% CI, 1.02-1.82]) and those who had Norton scores ≤ 13 (adjusted odds ratio = 1.60; P = 0.013 [95% CI, 1.10-2.31]). However, the model had a weak predictive efficacy (area under the curve = 0.577; P < 0.0001 [95% CI, 0.538-0.616]).
CONCLUSIONS
More adherence to food intake monitoring guidelines is needed.
目的
护士可以通过使用筛查工具和食物摄入量监测来识别营养不良风险。我们测量了食物摄入量报告的流行程度及其与营养不良筛查评分或其他患者特征的关系。
方法
这项回顾性队列研究收集了医院数据库中关于年龄≥18 岁、住院≥7 天且经口喂养或病历中未给予管饲或肠外营养的患者的信息。收集并对食物摄入量报告、营养不良通用筛查工具（MUST）评分、口服营养干预和其他次要特征进行了统计学分析。
结果
在 1 年内（2018 年 7 月 1 日至 2019 年 8 月 31 日），两个内科病房共收治了 5155 名患者，其中 1087 名符合纳入标准，平均年龄为 72.4±14.6 岁；其中，74.6%的患者有足够的食物摄入量报告。有三分之一的 MUST 评分≥2 的患者未报告食物摄入量。有报告食物摄入量和无报告食物摄入量的患者在 MUST 评分、性别、平均白蛋白水平、合并症、住院时间、全因院内死亡率、医院获得性压疮或口服营养干预率方面无差异。MUST 评分≥2 与摄入量报告无显著相关性。在年龄≥70 岁的患者（调整后的优势比=1.36；P=0.036[95%可信区间，1.02-1.82]）和 Norton 评分≤13 的患者（调整后的优势比=1.60；P=0.013[95%可信区间，1.10-2.31]）中，发现有更高的报告食物摄入量的可能性。然而，该模型的预测效能较弱（曲线下面积=0.577；P<0.0001[95%可信区间，0.538-0.616]）。
结论
需要更加遵守食物摄入量监测指南。
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