Munk Tina, Holmsted Signe Frederikke, Beck Anne Marie, Laursen Lise, Rasmussen Henrik Højgaard, Knudsen Anne Wilkens
The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
Clin Nutr ESPEN. 2025 Aug;68:523-529. doi: 10.1016/j.clnesp.2025.05.037. Epub 2025 May 28.
BACKGROUND & AIMS: A one-day cross-sectional study conducted at our hospital in 2019 found low achieved intake of energy and protein requirement among nutritional at-risk patients. Since then, a new energy and protein-dense digital food concept with a nutritional tracker to actively involve patients in their nutrition has been introduced. This study aimed to assess improvements in energy and protein intake, evaluate the performance of nutritional risk screening and documentation, examine hospital length of stay (LOS), prevalence of malnutrition, and rates of mortality and readmission.
A one-day cross-sectional study was performed in September 2023. Patients ≥18 years and hospitalized for ≥4 days were enrolled.
admission to the intensive, palliative, emergency, or maternal ward. Patients identified as at nutritional risk by the Nutritional Risk Screening tool (NRS-2002) underwent a 24-h dietary recall to evaluate their nutritional intake and adequacy. Malnutrition was assessed using the criteria of Global Leadership Initiative on Malnutrition (GLIM). Additional data were collected from the electronic medical records.
Out of 124 patients (52 % female) with a median age of 75 years (Interquartile Range (IQR): 66-83), 81 (65 %) were at nutrition risk. Dietary intake was assessed for 69 at-risk patients. Compared to 2019, more patients met 75 % of their energy (70 % vs. 35 %, p < 0.001) and protein (51 % vs. 24 %, p < 0.001) requirements. Energy and protein intake was documented for 42 % of patients but was inaccurate documented. Only 25 % were nutritionally screened within 24 h of admission. Among at-risk patients, 74 % (n = 58) were diagnosed with malnutrition. LOS was 13 days (IQR: 9-21), with readmission and mortality rates of 39 % and 22 %, respectively. No significant difference in LOS, readmission and mortality was found between nutritional at-risk and not at-risk patients.
The study indicated that actively involving nutritional at-risk patients in their own nutrition effectively increased energy and protein intake. The study revealed significant gaps in nutritional documentation and a high prevalence of malnutrition according to the GLIM criteria.
2019年在我院进行的一项为期一天的横断面研究发现，营养风险患者的能量和蛋白质摄入量未达需求。自那时起，引入了一种新的能量和蛋白质密集型数字食品概念，并配备营养追踪器，以促使患者积极参与自身营养管理。本研究旨在评估能量和蛋白质摄入量的改善情况，评估营养风险筛查和记录的执行情况，检查住院时间（LOS）、营养不良患病率以及死亡率和再入院率。
2023年9月进行了一项为期一天的横断面研究。纳入年龄≥18岁且住院≥4天的患者。
入住重症监护病房、姑息治疗病房、急诊病房或产科病房。通过营养风险筛查工具（NRS - 2002）确定为营养风险患者的患者接受24小时饮食回顾，以评估其营养摄入量和充足程度。使用全球营养不良领导倡议（GLIM）标准评估营养不良情况。从电子病历中收集其他数据。
在124例患者（52%为女性）中，年龄中位数为75岁（四分位间距（IQR）：66 - 83），81例（65%）存在营养风险。对69例有风险的患者进行了饮食摄入量评估。与2019年相比，更多患者达到了其能量需求的75%（70%对35%，p < 0.001）和蛋白质需求的75%（51%对24%，p < 0.001）。42%的患者记录了能量和蛋白质摄入量，但记录不准确。仅25%的患者在入院24小时内接受了营养筛查。在有风险的患者中，74%（n = 58）被诊断为营养不良。住院时间为13天（IQR：9 - 21），再入院率和死亡率分别为39%和22%。营养风险患者和非风险患者在住院时间、再入院率和死亡率方面未发现显著差异。
该研究表明，让营养风险患者积极参与自身营养管理有效地增加了能量和蛋白质摄入量。该研究揭示了营养记录方面存在显著差距，以及根据GLIM标准营养不良的高患病率。
