Clinical significance of nutritional risk screening for older adult patients with COVID-19
Clinical significance of nutritional risk screening for older adult patients with COVID-19
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DOI：
10.1038/s41430-020-0659-7
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发表时间：
2020-05-13
影响因子：
4.7
通讯作者：
Hu, Haifeng
中科院分区：
文献类型：
--
作者：
Liu, Gaoli;Zhang, Shaowen;Hu, Haifeng
本研究的目的是使用四种营养风险筛查（NRS）工具评估老年COVID-19患者的营养风险及其相关临床结局：营养风险筛查2002（NRS 2002），营养不良通用筛查工具（MUST），迷你营养评估工具（MNA-sf）和营养风险指数（NRI）。方法回顾性分析2020年1月28日至2020年3月5日在我院治疗的65岁以上COVID-19患者的资料，探讨营养风险与临床结局的关系。结果共有141例COVID-19患者（46例普通COVID-19，73例重症COVID-19，22例极重症COVID-19）入组研究。NRS 2002确定85.8%的患者存在风险，MUST确定41.1%，MNA-sf确定77.3%，NRI确定71.6%。NRS 2002与MNA-sf、NRI的一致性为中等，MUST与MNA-sf、NRI的一致性为中等，MNA-sf与NRI的一致性为中等，NRS 2002与MUST的一致性为差（P < 0.01）。多因素回归分析中调整混杂因素后，NRS 2002、MNA-sf和NRI评分显示，高危组患者的住院时间、住院费用（MNA-sf除外）、食欲差、疾病严重程度和体重变化（kg）均显著高于正常组（P < 0.05）。结论NRS 2002、MNA-sf和NRI是筛查存在营养风险以及需要额外营养干预的COVID-19患者的有用和实用工具。
Objectives The aim of this study was to assess the nutritional risks among older patients with COVID-19 and their associated clinical outcomes using four nutritional risk screening (NRS) tools: Nutrition Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), Mini Nutrition Assessment Shortcut (MNA-sf), and Nutrition Risk Index (NRI). Methods We retrospectively analyzed the data of patients with COVID-19 older than 65 years who were treated in our hospital from January 28, 2020 to March 5, 2020, and explored the relationship between nutritional risk and clinical outcomes. Results A total of 141 patients with COVID-19 (46 common COVID-19, 73 severe COVID-19, and 22 extremely severe COVID-19) were enrolled in the study. NRS 2002 identified 85.8% of patients as having risk, with being identified 41.1% by MUST, 77.3% by MNA-sf, and 71.6% by NRI. The agreement strength was moderate between NRS 2002 and MNA-sf, NRI, fair between MUST and MNA-sf, NRI, fair between MNA-sf and NRI, poor between NRS 2002 and MUST (P < 0.01). After adjustment for confounding factors in multivariate regression analysis, patients in the risk group had significantly longer LOS, higher hospital expenses (except MNA-sf), poor appetite, heavier disease severity, and more weight change(kg) than normal patients by using NRS 2002, MNA-sf, and NRI(P < 0.05). Conclusions The NRS 2002, MNA-sf, and NRI are useful and practical tools with respect to screening for patients with COVID-19 who are at nutritional risk, as well as in need of additional nutritional intervention.