Barriers to nutritional intake in patients with acute hip fracture: time to treat malnutrition as a disease and food as a medicine?
Barriers to nutritional intake in patients with acute hip fracture: time to treat malnutrition as a disease and food as a medicine?
复制标题
DOI：
10.1139/cjpp-2012-0301
复制
发表时间：
2013-06-01
影响因子：
2.1
通讯作者：
Pulle, Chrys Ranjeev
中科院分区：
文献类型：
--
作者：
Bell, Jack;Bauer, Judith;Pulle, Chrys Ranjeev
能量和蛋白质摄入不足会导致营养不良;急性髋部骨折后出现的一种临床疾病。详细描述营养不良患病率、发病率和摄入充足性的数据在该患者人群中差异很大。报告的干预策略的有限成功可能是由于诊断标准定义不明确，未能解决摄入量不足的根本原因，或与选择偏倚相关的错误。本实用性研究采用顺序、解释性混合方法设计，在44例急性髋部骨折患者（73%为女性;平均年龄81.7 ± 10.8岁）的代表性样本中确定营养不良的病因、患病率、发病率、摄入充足性和摄入障碍。入院时，营养不良患病率为52.2%。在58个称重的24小时食物记录中，能量和蛋白质需求仅满足两次。患者平均每日能量摄入量为2957 kJ（50.9 +/- 36.1 kJ.kg（-1）），平均蛋白质摄入量为22.8 g（0.6 +/- 0.46 g.kg（-1））。这导致住院病人营养不良的发生率进一步增加11%。摄入障碍包括患者认为营养不良和（或）摄入不足不是问题，以及患者和临床医生认为治疗营养不良不是优先事项。营养不良需要作为一种疾病来治疗，而不是没有后果，食物应该被认为是急性髋部骨折后的药物。
Inadequate energy and protein intake leads to malnutrition; a clinical disease not without consequence post acute hip fracture. Data detailing malnutrition prevalence, incidence, and intake adequacy varies widely in this patient population. The limited success of reported interventional strategies may result from poorly defined diagnostic criteria, failure to address root causes of inadequate intake, or errors associated with selection bias. This pragmatic study used a sequential, explanatory mixed methods design to identify malnutrition aetiology, prevalence, incidence, intake adequacy, and barriers to intake in a representative sample of 44 acute hip fracture patients (73% female; mean age, 81.7 +/- 10.8 years). On admission, malnutrition prevalence was 52.2%. Energy and protein requirements were only met twice in 58 weighed 24 h food records. Mean daily patient ;energy intake was 2957 kJ (50.9 +/- 36.1 kJ.kg(-1)) and mean protein intake was 22.8 g (0.6 +/- 0.46 g.kg(-1)). This contributed to a further in-patient malnutrition incidence of 11%. Barriers to intake included patient perceptions that malnutrition and (or) inadequate intake were not a problem, as well as patient and clinician perceptions that treatment for malnutrition was not a priority. Malnutrition needs to be treated as a disease not without consequence, and food should be considered as a medicine after acute hip fracture.