Arai Hideki, Okada Syuya, Fukuoka Tatsuyuki, Nozoe Masafumi, Kamiya Kuniyasu, Matsumoto Satoru
Department of Rehabilitation, Toyonaka Heisei Hospital, Toyonaka, Osaka, Japan.
Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashihiroshima, Hiroshima, Japan.
Arch Rehabil Res Clin Transl. 2024 Aug 2;6(3):100362. doi: 10.1016/j.arrct.2024.100362. eCollection 2024 Sep.
To evaluate the relationships between baseline nutritional status, medical events (MEs), and rehabilitation outcomes in individuals undergoing inpatient rehabilitation (IR).
A retrospective single center cohort study.
An IR ward.
This study included 409 patients (mean age, 80 years; men, 170 [42%]) undergoing IR for hospital-associated deconditioning, neurologic disorders, or musculoskeletal diseases. Participants were grouped according to the Controlling Nutritional Status score at admission: normal nutrition (NN): 0 to 1, mild malnutrition (MM): 2 to 4, and moderate/severe malnutrition (M/SM): 5 to 12.
None.
The primary outcomes included MEs leading to death or acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were the rehabilitation efficiency scores (changes in Functional Independence Measure [FIM] score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).
Among the 409 participants, 300 (73%) were malnourished at admission. The adjusted hazard ratios (95% confidence interval) for MEs in the MM and M/SM groups relative to the NN group were 1.48 (0.67-3.27) and 0.98 (0.34-2.81), respectively. No significant differences were observed among the 3 groups in FIM-M efficiency scores (mean ± SD, NN: 0.49±0.51 vs MM: 0.41±0.57 vs M/SM: 0.44±1.06, =.7) or FIM-C efficiency scores (0.04±0.06 vs 0.04±0.06 vs 0.08±0.4, =0.1). Analysis of covariance showed no significant association between MM or M/SM group and FIM-M efficiency score (beta coefficient = -0.038, =.6; beta coefficient = 0.15, =.1, respectively) or FIM-C efficiency score ( = 0.004, =.8; = 0.047, =.08, respectively).
No significant associations were observed between the baseline nutritional status and MEs, FIM-M efficiency score, or FIM-C efficiency score in individuals undergoing IR.
评估接受住院康复治疗（IR）的患者的基线营养状况、医疗事件（MEs）和康复结局之间的关系。
一项回顾性单中心队列研究。
一个IR病房。
本研究纳入了409例因医院相关性身体功能减退、神经系统疾病或肌肉骨骼疾病接受IR治疗的患者（平均年龄80岁；男性170例[42%]）。参与者根据入院时的控制营养状况评分进行分组：正常营养（NN）：0至1分，轻度营养不良（MM）：2至4分，中度/重度营养不良（M/SM）：5至12分。
无。
主要结局包括导致死亡或需要转至其他医院接受专科治疗的急性疾病的MEs。次要结局为运动功能（FIM-M）和认知功能（FIM-C）的康复效率评分（功能独立性测量[FIM]评分变化除以住院时间）。
在409名参与者中，300名（73%）入院时存在营养不良。MM组和M/SM组相对于NN组的MEs调整后风险比（95%置信区间）分别为1.48（0.67-3.27）和0.98（0.34-2.81）。三组在FIM-M效率评分（均值±标准差，NN：0.49±0.51 vs MM：0.41±0.57 vs M/SM：0.44±1.06，P = 0.7）或FIM-C效率评分（0.04±0.06 vs 0.04±0.06 vs 0.08±0.4，P = 0.1）方面未观察到显著差异。协方差分析显示，MM组或M/SM组与FIM-M效率评分（β系数=-0.038，P = 0.6；β系数=0.15，P = 0.1）或FIM-C效率评分（P = 0.004，P = 0.8；P = 0.047，P = 0.08）之间均无显著关联。
在接受IR治疗的患者中，未观察到基线营养状况与MEs、FIM-M效率评分或FIM-C效率评分之间存在显著关联。
