Reyes Laura Mola, García-Moreno Rosa M, López-Plaza Bricia, Milla Samara Palma
Clinical Nutrition and Dietetics Unit, Department of Endocrinology and Nutrition, Hospital Universitario La Paz, Paseo de la Castellana, No. 261, 28046 Madrid, Spain.
Food, Nutrition and Health Platform, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain.
Nutrients. 2024 Nov 28;16(23):4099. doi: 10.3390/nu16234099.
This study aimed to assess the prevalence and risk factors associated with disease-related malnutrition (DRM) in hospitalized patients using the Subjective Global Assessment (SGA) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Additionally, we sought to identify key determinants of moderate and severe malnutrition.
A retrospective analysis was conducted on 1036 adult patients hospitalized in a tertiary care hospital between August 2019 and November 2020. Nutritional status was evaluated using both the SGA and GLIM criteria. Data on demographic characteristics, comorbidities, dietary intake, and gastrointestinal symptoms were collected. Logistic regression models were employed to identify risk factors for DRM, and multivariate analysis was used to determine independent predictors.
The prevalence of DRM was 63.3% according to GLIM and 64.8% according to SGA. Moderate malnutrition was observed in 22.6% of patients, while 40.7% were classified as having severe malnutrition, and severe weight loss was noted in 34.5% of the subjects. The key risk factors for DRM included male sex (OR 1.67, < 0.0001), non-oncological gastrointestinal conditions (OR 1.48, = 0.041), infectious diseases (OR 1.66, = 0.007), inadequate ingestion (OR 5.13, < 0.0001), and the presence of gastrointestinal symptoms (OR 3.06, < 0.0001). Individualized diets were found to have a protective effect, while central parenteral nutrition significantly reduced the risk of severe DRM (OR 0.610, = 0.014). In the final adjusted model, sex ( < 0.0001), ingestion ( < 0.0001), and gastrointestinal symptoms ( < 0.0001) emerged as the most significant independent predictors of DRM.
The high prevalence of DRM in hospitalized patients emphasizes the importance of routine nutritional screening and personalized interventions. Proactive management of key risk factors such as inadequate intake and gastrointestinal symptoms is crucial to mitigating malnutrition and improving patient outcomes.
本研究旨在使用主观全面评定法（SGA）和全球营养不良领导倡议（GLIM）标准评估住院患者中与疾病相关的营养不良（DRM）的患病率及相关危险因素。此外，我们试图确定中度和重度营养不良的关键决定因素。
对2019年8月至2020年11月期间在一家三级护理医院住院的1036例成年患者进行回顾性分析。使用SGA和GLIM标准评估营养状况。收集有关人口统计学特征、合并症、饮食摄入和胃肠道症状的数据。采用逻辑回归模型确定DRM的危险因素，并进行多变量分析以确定独立预测因素。
根据GLIM标准，DRM的患病率为63.3%，根据SGA标准为64.8%。22.6%的患者存在中度营养不良，40.7%被归类为重度营养不良，34.5%的受试者出现严重体重减轻。DRM的关键危险因素包括男性（比值比1.67，<0.0001）、非肿瘤性胃肠道疾病（比值比1.48，=0.041）、传染病（比值比1.66，=0.007）、摄入不足（比值比5.13，<0.0001）以及存在胃肠道症状（比值比3.06，<0.0001）。发现个性化饮食具有保护作用，而中心静脉营养显著降低了重度DRM的风险（比值比0.610，=0.014）。在最终调整模型中，性别（<0.0001）、摄入（<0.0001）和胃肠道症状（<0.0001）成为DRM最显著的独立预测因素。
住院患者中DRM的高患病率强调了常规营养筛查和个性化干预的重要性。积极管理摄入不足和胃肠道症状等关键危险因素对于减轻营养不良和改善患者预后至关重要。
