The new ESPEN diagnostic criteria for malnutrition predict overall survival in hospitalised patients
The new ESPEN diagnostic criteria for malnutrition predict overall survival in hospitalised patients
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DOI：
10.1016/j.clnu.2016.11.018
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发表时间：
2018-02-01
影响因子：
6.3
通讯作者：
Kruizenga, H. M.
中科院分区：
文献类型：
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作者：
Rondel, A. L. M. A.;Langius, J. A. E.;Kruizenga, H. M.
背景资料：2015年，欧洲临床营养与代谢学会（ESPEN）提出了营养不良诊断的新共识标准。而大多数以前的定义是基于非自愿的体重减轻和/或低BMI，ESPEN的定义增加了无脂肪质量指数（FFMI）的一套criterial.Aim：研究新的ESPEN诊断标准的营养不良生存的预测价值，特别是关注FFMI的附加价值。方法：纳入了阿姆斯特丹自由大学医学中心的335例住院成人患者（60%为女性，年龄58 ± 18岁）。三套营养不良的标准被用来研究生存的预测价值：营养不良的荷兰定义，营养不良的ESPEN诊断标准和营养不良的ESPEN诊断标准没有FFMI标准。通过对数秩检验和考克斯回归分析营养不良与3个月和1年总生存率之间的关系。在多变量分析中，调整性别，年龄，护理复杂性和stays.Results的长度：90例（27%）被归类为营养不良的任何一套标准，营养不良的患者有显着低于非营养不良患者的生存率在三个月（84%vs 94%; P = 0.01）和一年（76%vs 87%; P = 0.02）。调整后，营养不良与荷兰营养不良定义（HR：2.25，p = 0.04）和ESPEN营养不良诊断标准（HR：2.76，p = 0.02）的3个月生存率显著相关。营养不良仍然与一年生存率显著相关的营养不良的ESPEN诊断标准（HR：2.17，p < 0.02）和营养不良的ESPEN诊断标准无FFMI（HR：2.66，p < 0.01）。结论：营养不良的新ESPEN定义是预测三个月和一年生存在综合医院人群，而定义无FFMI是预测三个月或一年生存。(C)2016爱思唯尔有限公司和欧洲临床营养与代谢学会。All rights reserved.
Background: In 2015 the European Society for Clinical Nutrition and Metabolism (ESPEN) presented new consensus criteria for the diagnosis of malnutrition. Whereas most previous definitions were based on involuntary weight loss and/or a low BMI, the ESPEN definition added Fat Free Mass Index (FFMI) to the set of criteria.Aim: To study the predictive value of the new ESPEN diagnostic criteria for malnutrition on survival, with specific focus on the additional value of FFMI.Methods: Included were 335 hospitalized adult patients of the VU University Medical Center Amsterdam (60% female, age 58 +/- 18 y). Three sets of criteria for malnutrition were used to study the predictive value for survival: Dutch definition for malnutrition, ESPEN diagnostic criteria for malnutrition and ESPEN diagnostic criteria for malnutrition without FFMI criterion. The association between malnutrition and three-months and one-year overall survival was analyzed by log rank tests and Cox regression. In multivariate analyses, adjustments were made for gender, age, care complexity and length of stay.Results: Ninety patients (27%) were classified as malnourished by any of the sets of criteria; malnourished patients had significant lower survival rates than non-malnourished patients at three months (84% vs 94%; p = 0.01) and one year (76% vs 87%; p = 0.02). After adjustments, malnutrition remained significantly associated with three-months survival for the Dutch definition for malnutrition (HR:2.25, p = 0.04) and the ESPEN diagnostic criteria for malnutrition (HR:2.76, p = 0.02). Malnutrition remained significantly associated with one-year survival for the ESPEN diagnostic criteria for malnutrition (HR:2.17, p < 0.02) and the ESPEN diagnostic criteria for malnutrition without FFMI (HR:2.66, p < 0.01).Conclusion: The new ESPEN definition for malnutrition is predictive for both three-months and one-year survival in a general hospital population, whereas definitions without FFMI are predictive for either three-months or one year survival. (C) 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.