IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy.
Human Nutrition and Dietetics, Department of Public Health, Federico II University, 80131 Naples, Italy.
Nutrients. 2023 Jul 27;15(15):3336. doi: 10.3390/nu15153336.
Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an expected negative impact on clinical outcomes and pressure ulcers (PUs) in particular. In a retrospective cohort study on patients discharged from intensive care units (ICU) and admitted to an intensive rehabilitation unit (IRU), the risk of malnutrition was systematically assessed, in addition to standard clinical procedures (including PUs evaluation), using two different tools: the Malnutrition Universal Screening Tool (MUST) and the Controlling Nutritional Status (CONUT) tool. Eighty-eight patients were included in the analysis. A high proportion (79.5%) of patients with sABI suffered from PUs, being older and more frequently men, with a longer ICU stay between the event and admission to IRU, and a greater MUST score. At discharge, when compared to patients whose PUs had healed, those with persisting PUs were more often men and had the worst cognitive performance at admission. As for nutritional risk, the baseline CONUT score was identified as an independent negative predictor of PUs at discharge by the logistic regression model. In conclusion, the assessment of nutritional risk using simple standard tools may be useful in the clinical evaluation of sABI patients with PUs.
文献中的初步证据表明,严重后天性脑损伤(sABI)患者存在较高的营养不良(营养不足)发生率,这对临床结局,尤其是压疮(PU)有负面的影响。在一项对从重症监护病房(ICU)出院并转入强化康复病房(IRU)的患者的回顾性队列研究中,除了标准临床程序(包括 PU 评估)外,还使用两种不同的工具:营养不良通用筛查工具(MUST)和控制营养状况(CONUT)工具,系统性地评估了营养不良的风险。共有 88 名患者纳入分析。患有 sABI 的患者中,有很大一部分(79.5%)患有 PU,他们更年长,且更多为男性,从事件发生到转入 IRU 的 ICU 住院时间更长,MUST 评分更高。在出院时,与 PU 已愈合的患者相比,持续存在 PU 的患者更多为男性,且入院时的认知功能最差。至于营养风险,逻辑回归模型确定,基线 CONUT 评分是出院时发生 PU 的独立负性预测因子。总之,使用简单标准工具评估营养风险可能有助于对患有 PU 的 sABI 患者进行临床评估。