衰弱和GLIM定义的营养不良会导致普通外科老年住院患者的临床预后不良。
Frailty and GLIM-defined malnutrition contribute to poor clinical outcomes in older adult inpatients in the general surgery department.
作者信息
Liu Chengyu, Chen Liru, Liu Peng, Li Lei, Cheng Bo, Xu Jingyong, Cui Hongyuan, Zhu Mingwei
机构信息
Department of General Surgery, Department of Hepato-bilio-pancreatic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Department of Nutrition, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
Front Nutr. 2025 Jun 30;12:1435429. doi: 10.3389/fnut.2025.1435429. eCollection 2025.
BACKGROUND AND AIMS
Frailty and malnutrition are prevalent among older adult inpatients. Our study aimed to analyze the correlation between frailty and malnutrition and determine their effects on the clinical outcomes in older adult surgical inpatients.
METHODS
This cross-sectional observational study included older adult inpatients (≥ 65 years old) undergoing scheduled surgery. Anthropometric measurements and hematological examination results were collected at the time of admission. Frailty and malnutrition were assessed using the frailty phenotype and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Nutritional support during hospitalization and clinical outcomes, such as the occurrence of postoperative complications, in-hospital death, length of hospital stays, and hospital costs, were recorded. The chi-squared and rank-sum tests were used for comparison. Univariate and multivariate logistic regression analyses were used to calculate the odds ratios (OR) and 95% confidence intervals (CI) for frailty, malnutrition, and postoperative complications.
RESULTS
In 394 patients, the frailty prevalence was 17.3% (68/394), and 146 inpatients (37.1%) were malnourished. The overlapping prevalence rate of frailty and malnutrition was 12.2% (48/394). Frailty and malnutrition were correlated (r = 0.464, < 0.001). Multivariate analysis revealed that frailty significantly increased the risk of postoperative complications (OR: 2.937, 95% CI: 1.475-5.850, = 0.002). There were significant differences in the length of hospital stays and hospital costs among the four groups of patients with frailty and malnutrition, frailty and no malnutrition, malnutrition and no frailty, and no frailty and malnutrition ( < 0.001; < 0.001).
CONCLUSION
A significant positive correlation was observed between frailty and malnutrition. Frailty and malnutrition are significantly associated with adverse clinical outcomes. Therefore, it is necessary to manage frailty and malnutrition to improve the prognosis.
背景与目的
衰弱和营养不良在老年住院患者中普遍存在。我们的研究旨在分析衰弱与营养不良之间的相关性，并确定它们对老年外科住院患者临床结局的影响。
方法
这项横断面观察性研究纳入了计划接受手术的老年住院患者（≥65岁）。入院时收集人体测量数据和血液学检查结果。使用衰弱表型和全球营养不良领导倡议（GLIM）标准评估衰弱和营养不良情况。记录住院期间的营养支持情况以及临床结局，如术后并发症的发生、院内死亡、住院时间和住院费用。采用卡方检验和秩和检验进行比较。单因素和多因素逻辑回归分析用于计算衰弱、营养不良和术后并发症的比值比（OR）及95%置信区间（CI）。
结果
在394例患者中，衰弱患病率为17.3%（68/394），146例住院患者（37.1%）存在营养不良。衰弱与营养不良的重叠患病率为12.2%（48/394）。衰弱与营养不良具有相关性（r = 0.464，P < 0.001）。多因素分析显示，衰弱显著增加了术后并发症的风险（OR：2.937，95%CI：1.475 - 5.850，P = 0.002）。在衰弱且营养不良、衰弱但无营养不良、营养不良但无衰弱以及无衰弱且无营养不良这四组患者中，住院时间和住院费用存在显著差异（P < 0.001；P < 0.001）。
结论
观察到衰弱与营养不良之间存在显著正相关。衰弱和营养不良与不良临床结局显著相关。因此，有必要管理衰弱和营养不良以改善预后。
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