Golder Janet E, Bauer Judy D, Barker Lisa A, Lemoh Christopher N, Gibson Simone J, Davidson Zoe E
Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia.
Workforce, Innovation, Strategy, Education and Research (WISER) Unit, Allied Health, Monash Health, Victoria, Australia.
Nutr Diet. 2025 Apr;82(2):152-162. doi: 10.1111/1747-0080.12918. Epub 2024 Dec 8.
To explore the prevalence of vitamin C deficiency, 'undetectable' vitamin C status, and scurvy features, in adult hospitalised patients with protein-energy malnutrition diagnosed using validated malnutrition screening and assessment tools commonly used in clinical practice.
This study included adult inpatients from four acute hospitals within a single Australian tertiary health service, over a 3.5-year period. A medical file review activity retrospectively determined malnutrition risk and diagnosis, via Malnutrition Screening Tool, Malnutrition Universal Screening Tool, Subjective Global Assessment and Global Leadership Initiative on Malnutrition criteria. Prevalence of vitamin C deficiency and scurvy features was examined in adult patients with plasma vitamin C levels <11.4 μmol/L and <5 μmol/L ('undetectable'), respectively.
In the final cohort (n = 364), prevalence of vitamin C deficiency was 30.2%. Malnutrition was present in 76.1% and 79.8% of patients via Subjective Global Assessment (n = 310) and Global Leadership Initiative on Malnutrition criteria (n = 342) respectively. Patients with high nutrition risk and those diagnosed with severe malnutrition had the highest prevalence of vitamin C deficiency, reported as 32.8% for malnutrition detected via Malnutrition Screening Tool (n = 244), 32.9% via Malnutrition Universal Screening Tool (n = 222), 35.8% via Subjective Global Assessment (n = 106), and 34.2% via Global Leadership Initiative on Malnutrition (n = 152). Scurvy features were associated with severe malnutrition in patients with 'undetectable' vitamin C status.
Severely malnourished adult hospital patients have a high prevalence of vitamin C deficiency, and scurvy features in those with 'undetectable' vitamin C status. Leveraging existing malnutrition screening and assessment practices may support early identification of patients with vitamin C deficiency during hospitalisation.
探讨在使用临床实践中常用的经过验证的营养不良筛查和评估工具诊断为蛋白质 - 能量营养不良的成年住院患者中，维生素C缺乏、“检测不到”的维生素C状态以及坏血病特征的患病率。
本研究纳入了澳大利亚一家三级医疗服务机构内四家急症医院的成年住院患者，研究为期3.5年。通过营养不良筛查工具、营养不良通用筛查工具、主观全面评定法和全球营养不良领导倡议标准，回顾性地审查医疗档案活动来确定营养不良风险和诊断。分别在血浆维生素C水平<11.4 μmol/L和<5 μmol/L（“检测不到”）的成年患者中检查维生素C缺乏和坏血病特征的患病率。
在最终队列（n = 364）中，维生素C缺乏的患病率为30.2%。通过主观全面评定法（n = 310）和全球营养不良领导倡议标准（n = 342）分别有76.1%和79.8%的患者存在营养不良。营养风险高的患者和被诊断为严重营养不良的患者维生素C缺乏的患病率最高，通过营养不良筛查工具检测到营养不良的患者中为32.8%（n = 244），通过营养不良通用筛查工具检测到营养不良的患者中为32.9%（n = 222），通过主观全面评定法检测到营养不良的患者中为35.8%（n = 106），通过全球营养不良领导倡议标准检测到营养不良的患者中为34.2%（n = 152）。在维生素C状态“检测不到”的患者中，坏血病特征与严重营养不良相关。
严重营养不良的成年住院患者维生素C缺乏的患病率很高，且在维生素C状态“检测不到”的患者中存在坏血病特征。利用现有的营养不良筛查和评估实践可能有助于在住院期间早期识别维生素C缺乏的患者。
