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综合老年评估在老年患者不同营养状况识别中的作用:一项真实世界横断面研究。

The role of comprehensive geriatric assessment in the identification of different nutritional status in geriatric patients: a real-world, cross-sectional study.

作者信息

Ju Yanmin, Lin Xiaoye, Zhang Kexin, Yang Di, Cao Mengyu, Jin Huijing, Leng Jiyan

机构信息

Department of Cadre Ward, The First Hospital of Jilin University, Changchun, Jilin, China.

出版信息

Front Nutr. 2024 Jan 8;10:1166361. doi: 10.3389/fnut.2023.1166361. eCollection 2023.

Abstract

BACKGROUND

Malnutrition is an often unrecognized problem, but it is common in older patients and leads to adverse outcomes.

AIMS

The purpose of this study is to analyze the prevalence of the risk of undernutrition in elderly patients and the correlation between CGA and nutritional status, and to determine the nutritional status of elderly patients.

METHODS

This is a real-world cross-sectional study of continuously enrolled elderly patients aged 65 years or older with a complete CGA database. CGA inventory was prepared by compiling and screening general information, body composition and blood biochemical results. MNA was also conducted for each elderly patient to screen for malnutrition. A multivariable logistic regression analysis was used to determine the association between the CGA and nutritional assessment.

RESULT

The average age of the 211 selected elderly patients (160 men and 51 women) was 79.60 ± 9.24 years, and their ages ranged from 65 to 96 years. After controlling for confounders, patients with a history of PUD (OR = 2.353,  = 0.044), increased ADLs & IADLs scores (OR = 1.051,  = 0.042) or GDS scores (OR = 6.078,  < 0.001) may increase the incidence of the risk of undernutrition respectively, while an increase in BMI (OR = 0.858,  = 0.032) may lower the incidence of malnutrition risk. In addition, increased ADLs & IADLs scores (OR = 1.096,  = 0.002) or GDS scores (OR = 11.228,  < 0.001) may increase the incidence of undernutrition. However, increased MMSE (OR = 0.705,  < 0.001), BMI (OR = 0.762,  = 0.034), UAC (OR = 0.765,  = 0.048) and CC (OR = 0.721, 0.003) may decrease the incidence of undernutrition, respectively.

CONCLUSION

The study found that the prevalence of risk of undernutrition in elderly patients was the highest. Risk of undernutrition was independently associated with peptic ulcer disease, ADLs & IADLs, GDS and BMI. However, we found that when the nutritional status reached the level of undernutrition, it was related to more factors, including ADLs & IADLs, MMSE, GDS, BMI, UAC and CC. Determining the level of malnutrition through CGA may help to prevent and intervene malnutrition as early as possible.

摘要

背景

营养不良是一个常常未被认识到的问题,但在老年患者中很常见,并会导致不良后果。

目的

本研究旨在分析老年患者营养不良风险的患病率以及综合老年评估(CGA)与营养状况之间的相关性,并确定老年患者的营养状况。

方法

这是一项对连续纳入的65岁及以上且拥有完整CGA数据库的老年患者进行的真实世界横断面研究。通过汇编和筛选一般信息、身体成分及血液生化结果来编制CGA清单。还对每位老年患者进行了营养不良通用筛查工具(MNA)评估以筛查营养不良情况。采用多变量逻辑回归分析来确定CGA与营养评估之间的关联。

结果

入选的211例老年患者(160例男性和51例女性)平均年龄为79.60±9.24岁,年龄范围为65至96岁。在控制混杂因素后,有消化性溃疡病史的患者(比值比[OR]=2.353,P=0.044)、日常生活活动能力(ADLs)和工具性日常生活活动能力(IADLs)评分增加(OR=1.051,P=0.042)或老年抑郁量表(GDS)评分增加(OR=6.078,P<0.001)可能分别增加营养不良风险的发生率,而体重指数(BMI)增加(OR=0.858,P=0.032)可能降低营养不良风险的发生率。此外,ADLs和IADLs评分增加(OR=1.096,P=0.002)或GDS评分增加(OR=11.228,P<0.00)可能增加营养不良的发生率。然而,简易精神状态检查表(MMSE)增加(OR=0.70 ,P<0.001)、BMI增加(OR=0.762,P=)、上臂围(UAC)增加(OR=0.765,P=0.048)和小腿围(CC)增加(OR=0.721,P=0.003)可能分别降低营养不良的发生率。

结论

研究发现老年患者中营养不良风险的患病率最高。营养不良风险与消化性溃疡疾病、ADLs和IADLs、GDS及BMI独立相关。然而,我们发现当营养状况达到营养不良水平时,它与更多因素相关,包括ADLs和IADLs、MMSE、GDS、BMI、UAC和CC。通过CGA确定营养不良水平可能有助于尽早预防和干预营养不良。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b06c/10800699/a04cbcb1b5a1/fnut-10-1166361-g001.jpg

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