Buckler D A, Kelber S T, Goodwin J S
University of Wisconsin Medical School, Milwaukee.
J Am Geriatr Soc. 1994 Oct;42(10):1100-2. doi: 10.1111/j.1532-5415.1994.tb06216.x.
To evaluate the dietary prescriptions of nursing home patients who show evidence of malnutrition.
A descriptive chart review.
Four chronic care facilities in Milwaukee, Wisconsin.
A total of 336 charts were randomly selected from the four facilities. Analysis was done on the 217 charts that included a recorded serum albumin.
Serum albumin, height, most recent weight, weight recorded 6 months previously, major diagnoses, and current diets were recorded. Average weight change per month and body mass index were calculated.
In 109 of the 217 patients, the serum albumin was less than 3.5 g/dL. 75.2 percent of hypoalbuminic patients were on some sort of dietary restriction, including caloric restriction in 18% and sodium restriction in 35%. Sixty-six of the 217 patients had an average weight loss of greater than 1 pound per month, and 59% of this group were on dietary restrictions, with 21% on sodium restriction and 20% on limited calories.
Malnutrition is a common problem in the nursing home population. A restricted diet is one possible factor that might contribute to this. While this study does not prove a causal relationship between a restricted diet and malnutrition, it would seem inappropriate that most patients with evidence of malnutrition are on diets that might discourage nutrient intake.
评估有营养不良迹象的疗养院患者的饮食处方。
描述性图表回顾。
威斯康星州密尔沃基的四家慢性病护理机构。
从这四家机构中随机抽取了336份病历。对其中217份记录了血清白蛋白的病历进行分析。
记录血清白蛋白、身高、最近体重、6个月前记录的体重、主要诊断和当前饮食。计算每月平均体重变化和体重指数。
217名患者中有109名血清白蛋白低于3.5 g/dL。75.2%的低白蛋白血症患者有某种饮食限制，包括18%的热量限制和35%的钠限制。217名患者中有66名平均每月体重减轻超过1磅，该组中59%的患者有饮食限制，21%的患者限制钠摄入，20%的患者限制热量摄入。
营养不良是疗养院人群中的常见问题。饮食限制是可能导致这一问题的一个因素。虽然这项研究没有证明饮食限制与营养不良之间存在因果关系，但大多数有营养不良迹象的患者采用可能不利于营养摄入的饮食似乎是不合适的。
