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老年人营养不良患者出院后 30 天内再住院的风险:一项荟萃分析。

The risk of rehospitalization within 30 days of discharge in older adults with malnutrition: A meta-analysis.

机构信息

Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Kampus Baru UI Depok, West Java, Indonesia; Department of Internal Medicine, Dr. Cipto Mangunkusumo Hospital, Salemba, Jakarta, Indonesia; Faculty of Medicine, Universitas Indonesia, Salemba, Jakarta, Indonesia.

Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Kampus Baru UI Depok, West Java, Indonesia.

出版信息

Arch Gerontol Geriatr. 2024 Mar;118:105306. doi: 10.1016/j.archger.2023.105306. Epub 2023 Dec 2.

Abstract

INTRODUCTION

Malnutrition is a global health problem associated with higher rehospitalization risk, subsequently increasing the risks of adverse complications, and mortality in older individuals. Nevertheless, studies investigating this are still scarce, and even fewer reviewed and aggregated. A number of studies have recently assessed the correlation of malnourishment with rehospitalization among older adults.

OBJECTIVE/AIM: This systematic review and meta-analysis aimed to elaborate the correlation between malnutrition and 30-day rehospitalization in older adults.

METHODS

Systematic review was conducted on literatures from Cochrane, ScienceDirect, SpringerLink, Oxford Academic, and MEDLINE according to PRISMA Guideline, investigating the correlation of malnutrition in older adults with rehospitalization, using Malnutrition, Older Adults, and Rehospitalization as keywords. Meta-analysis was done using RevMan, with random-effect analysis model. P values of ≤0.05 were considered statistically significant with results reported as risk ratios (RR), mean differences (MD), 95 % confidence intervals (CI) and I statistics.

RESULTS

Seven literatures were analysed, consisting of 19,340 patients aged 65 or older undergoing hospitalization. Subjects were assessed with screening tools to identify malnutrition. Malnourished subjects are compared to others with normal nutrition; in cohort studies with follow-up period ranging from 3 to 16 months. Malnutrition significantly increased the risks of rehospitalization within 30 days (RR 1.73 [95 % CI 1.10-2.72], p = 0.02, I = 56 %), overall rehospitalization at all times (RR 1.33 [95 % CI 1.16-1.52], p < 0.0001, I = 75 %), and overall mortality (RR 2.66 [95 % CI 1.09-6.50], p = 0.03, I = 94 %).

CONCLUSION

Malnutrition exhibited significant consequences in older patients regarding the rate of rehospitalization and mortality based on this meta-analysis. Further research is highly encouraged to verify this finding.

摘要

简介

营养不良是一个全球性的健康问题,与更高的再住院风险相关,进而增加了老年人发生不良并发症和死亡的风险。然而,对此进行研究的文献仍然很少,进行综述和综合分析的就更少了。最近有许多研究评估了老年人营养不良与再住院之间的相关性。

目的/目标:本系统综述和荟萃分析旨在阐述老年人营养不良与 30 天内再住院之间的相关性。

方法

根据 PRISMA 指南,对 Cochrane、ScienceDirect、SpringerLink、Oxford Academic 和 MEDLINE 中的文献进行系统综述,使用“营养不良、老年人和再住院”作为关键词,调查老年人营养不良与再住院的相关性。使用 RevMan 进行荟萃分析,采用随机效应分析模型。P 值≤0.05 被认为具有统计学意义,结果以风险比(RR)、均数差(MD)、95%置信区间(CI)和 I 统计量表示。

结果

分析了 7 篇文献,共纳入 19340 名年龄在 65 岁或以上的住院患者。采用筛查工具评估患者是否存在营养不良。将营养不良的患者与营养正常的患者进行比较;在随访时间为 3 至 16 个月的队列研究中。30 天内再住院的风险显著增加(RR 1.73[95%CI 1.10-2.72],p=0.02,I=56%),所有时间的再住院风险(RR 1.33[95%CI 1.16-1.52],p<0.0001,I=75%)和全因死亡率(RR 2.66[95%CI 1.09-6.50],p=0.03,I=94%)。

结论

根据这项荟萃分析,营养不良对老年患者的再住院率和死亡率有显著影响。强烈鼓励进一步研究以验证这一发现。

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