Saito Tsukasa, Kamachi Masafumi
Department of Rehabilitation, Social Medical Corporation Monju-group Kameda Hospital, Hakodate, Hokkaido, Japan.
Department of Internal Medicine, Social Medical Corporation Monju-group Kameda Hospital, Hakodate, Hokkaido, Japan.
Jpn J Compr Rehabil Sci. 2024 Oct 16;15:71-78. doi: 10.11336/jjcrs.15.71. eCollection 2024.
Saito T, Kamachi M. Actual situation of nutritional management and factors related to activities of daily living ability at discharge in convalescent rehabilitation ward. Jpn J Compr Rehabil Sci 2024; 15: 71-78.
In this study, we aimed to investigate changes in the Geriatric Nutritional Risk Index (GNRI), a nutrition-related prognostic indicator, in our convalescent rehabilitation ward and determine how this index relates to activities of daily living (ADL) ability at discharge.
We retrospectively analyzed data of 107 patients admitted to our convalescent rehabilitation ward between April and September 2023. We used the GNRI as the nutritional risk index and Functional Independence Measure (FIM) as the ADL index.
The patients' mean age was 80.0 ± 10.3 years; 38 were males and 69 females. The patients' mean body weight at admission was 51.2 ± 10.2 kg, which significantly decreased to 50.2 ± 9.4 kg at discharge ( = 0.0006). Their mean body mass index (BMI) also significantly decreased from 21.4 ± 3.4 at admission to 20.0 ± 8.2 at discharge ( = 0.002). The mean GNRI significantly decreased from 93.1 ± 8.6 at admission to 91.7 ± 8.4 at discharge ( = 0.023). The mean body weight decreased until the fourth month after admission; however, no decreasing trend after the fifth month was observed. The mean monthly energy intake gradually increased after admission and reached the calculated energy requirement of 1,415 ± 22 kcal at the fifth month. Multivariate analysis demonstrated that at discharge, the GNRI score was positively associated with the FIM score ( = 0.21, = 0.0008).
Body weight and GNRI scores decreased after admission but stopped decreasing after the fifth month due to a gradual increase in energy intake. At discharge, the FIM score was positively associated with the GNRI score. We expected that active nutritional therapy from the beginning of hospitalization would increase the GNRI by the time of discharge and eventually improve ADL ability at discharge.
斋藤T，镰achi M。疗养康复病房营养管理的实际情况及出院时与日常生活能力相关的因素。日本综合康复科学杂志2024；15：71 - 78。
在本研究中，我们旨在调查老年营养风险指数（GNRI）这一营养相关预后指标在我们疗养康复病房中的变化，并确定该指数与出院时日常生活活动（ADL）能力的关系。
我们回顾性分析了2023年4月至9月期间入住我们疗养康复病房的107例患者的数据。我们将GNRI用作营养风险指数，将功能独立性测量（FIM）用作ADL指数。
患者的平均年龄为80.0±10.3岁；男性38例，女性69例。患者入院时的平均体重为51.2±10.2千克，出院时显著降至50.2±9.4千克（P = 0.0006）。他们的平均体重指数（BMI）也从入院时的21.4±3.4显著降至出院时的20.0±8.2（P = 0.002）。平均GNRI从入院时的93.1±8.6显著降至出院时的91.7±8.4（P = 0.023）。平均体重在入院后第四个月前下降；然而，在第五个月后未观察到下降趋势。入院后平均每月能量摄入量逐渐增加，在第五个月达到计算的能量需求1415±22千卡。多变量分析表明，出院时，GNRI评分与FIM评分呈正相关（P = 0.21，P = 0.0008）。
入院后体重和GNRI评分下降，但由于能量摄入量逐渐增加，在第五个月后停止下降。出院时，FIM评分与GNRI评分呈正相关。我们期望从住院开始积极的营养治疗能在出院时提高GNRI，并最终改善出院时ADL能力。
