Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam-si, South Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea.
Eur J Clin Nutr. 2024 Sep;78(9):765-771. doi: 10.1038/s41430-024-01463-3. Epub 2024 Jun 19.
The South Korean government implemented a multidisciplinary nutritional support team (NST) system to focus on the proper evaluation and supply of nutritional status in hospitalized patients who are at a higher risk of malnutrition.
This nationwide population-based cohort study included patients diagnosed with sepsis who were admitted to hospitals from 2016 to 2020. The NST should consist of four professional personnel (physicians, full-time nurses, full-time pharmacists, and full-time clinical dietitians). The NST group included patients with sepsis admitted to a hospital with an NST system, whereas the non-NST group included patients with sepsis admitted to a hospital without an NST system.
A total of 323,841 patients with sepsis were included in the final analysis, and 120,274 (37.1%) admitted to a hospital with an NST system were included in the NST group. In the multivariable Cox regression analysis, the NST group showed a 15% lower 90-day mortality than the non-NST group (hazard ratio [HR]:0.85, 95% confidence interval [CI]:0.83, 0.86; P < 0.001). The NST group shows 11% lower 1-year all-cause mortality than the non-NST group (HR:0.89, 95% CI:0.87, 0.90; P < 0.001). In subgroup analyses, a more evident association of the NST group with lower 90-day mortality was shown in the intensive care unit admission group and age ≥65 years old group.
Multidisciplinary NST intervention is associated with improved survival outcomes in patients with sepsis. Moreover, this association was more evident in patients with sepsis aged ≥65 years old who were admitted to the ICU.
韩国政府实施了多学科营养支持团队（NST）系统，专注于评估和供应营养状况，以预防住院患者营养不良。
本项全国性基于人群的队列研究纳入了 2016 年至 2020 年期间因败血症住院的患者。NST 应由四名专业人员（医生、全职护士、全职药剂师和全职临床营养师）组成。NST 组包括在有 NST 系统的医院住院的败血症患者，而非 NST 组包括在没有 NST 系统的医院住院的败血症患者。
共有 323841 名败血症患者纳入最终分析，其中 120274 名（37.1%）入住有 NST 系统的医院，纳入 NST 组。在多变量 Cox 回归分析中，NST 组 90 天死亡率较非 NST 组低 15%（风险比[HR]：0.85，95%置信区间[CI]：0.83，0.86；P<0.001）。NST 组 1 年全因死亡率较非 NST 组低 11%（HR：0.89，95% CI：0.87，0.90；P<0.001）。亚组分析显示，在 ICU 入院组和年龄≥65 岁组中，NST 组与较低的 90 天死亡率之间的关联更为明显。
多学科 NST 干预与败血症患者的生存结果改善相关。此外，在 ICU 入院和年龄≥65 岁的败血症患者中，这种相关性更为明显。
