Ishiwari Mayuko, Kono Yuta, Togashi Yuki, Kobayashi Kenichi, Kikuchi Ryota, Kogami Mariko, Suekawa Ami, Miyazawa Yasushi, Abe Shinji
Department of Respiratory Medicine, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Department of Nutrition Management, Tokyo Medical University Hospital, Tokyo, Japan.
BMC Geriatr. 2025 Feb 19;25(1):113. doi: 10.1186/s12877-025-05767-2.
Studies of nutritional status in geriatric patients with respiratory diseases are limited. The aim of this study was to investigate the mortality risk of older patients undergoing urgent hospitalization for various respiratory diseases.
This was a retrospective study of patients aged ≥ 65 years with respiratory diseases who were urgently hospitalized between April 2022 and November 2024. The Mini Nutritional Assessment Short-Form (MNA-SF) was evaluated at the time of urgent admission, and the malnutrition risk was defined by the MNA-SF score < 11. Comorbidities and frailty were assessed using the Charlson comorbidity index (CCI) and Clinical frailty scale (CFS), respectively. Biomarkers of inflammation and acute respiratory failure such as neutrophil-to-lymphocyte ratio (NLR), Glasgow Prognostic Score (GPS), Respiratory rate-oxygenation (ROX) index, and the pulse oximetric saturation (SpO)/fraction of inspired oxygen (FiO) [S/F] ratio were calculated and analyzed as risk factors of in-hospital mortality.
A total of 168 consecutive patients were enrolled in the study with median age of 77 years (interquartile range [IQR]: 72-84). Thirty-nine patients (23.2%) died during hospitalization, and the median time to death was 17 days (IQR: 10-25). Univariate analysis demonstrated that older age (> 77 years), low S/F ratio (< 315), low ROX (< 8.3), high NLR (> 6), high CFS (> 5), and low MNA-SF (< 11) were associated with in-hospital mortality, multivariate analysis revealed that low MNA-SF was an independent predictor.
The MNA-SF is a risk factor for mortality in older patients undergoing urgent hospitalization due to various respiratory diseases.
关于老年呼吸系统疾病患者营养状况的研究有限。本研究旨在调查因各种呼吸系统疾病紧急住院的老年患者的死亡风险。
这是一项对2022年4月至2024年11月期间因呼吸系统疾病紧急住院的≥65岁患者的回顾性研究。在紧急入院时评估简易营养评估简表(MNA-SF),营养不良风险定义为MNA-SF评分<11。分别使用Charlson合并症指数(CCI)和临床衰弱量表(CFS)评估合并症和衰弱情况。计算并分析炎症和急性呼吸衰竭的生物标志物,如中性粒细胞与淋巴细胞比值(NLR)、格拉斯哥预后评分(GPS)、呼吸频率-氧合(ROX)指数以及脉搏血氧饱和度(SpO)/吸入氧分数(FiO)[S/F]比值,作为住院死亡率的危险因素。
共纳入168例连续患者,中位年龄为77岁(四分位间距[IQR]:72-84)。39例患者(23.2%)在住院期间死亡,中位死亡时间为17天(IQR:10-25)。单因素分析表明,年龄较大(>77岁)、低S/F比值(<315)、低ROX(<8.3)、高NLR(>6)、高CFS(>5)和低MNA-SF(<11)与住院死亡率相关,多因素分析显示低MNA-SF是独立预测因素。
MNA-SF是因各种呼吸系统疾病紧急住院的老年患者死亡的危险因素。