Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital
Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital
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DOI：
10.1016/j.clnu.2014.04.014
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发表时间：
2015-06-01
影响因子：
6.3
通讯作者：
Clave, Pere
中科院分区：
文献类型：
--
作者：
Carrion, Silvia;Cabre, Mateu;Clave, Pere
研究背景：口咽吞咽困难和营养不良是老年人的常见疾病。本研究的目的是探讨口咽吞咽困难，营养状况和临床结果之间的关系，在老年患者入院急性geriatric unit.Methods：我们研究了1662例患者>= 70年连续住院的急性疾病，其中吞咽困难可以临床评估的体积粘度吞咽试验和营养状况的迷你营养评估。结果：47.4%（95% CI 45 ~ 49.8%）的患者出现口咽部吞咽困难，30.6%（95% CI 27.9%~ 33.3%）的患者出现营养不良。这两种情况都与多发性硬化、多发性老年综合征和功能低下有关（p < 0.001）。然而，吞咽困难患者的营养不良患病率增加（MNA（R）< 1745.3% vs 18%，p < 0.001），无论其功能状态和合并症如何（OR 2.31（1.70-3.14）），白蛋白和胆固醇水平较低。营养不良患者吞咽困难的患病率增加（68.4%（95%CI 63.3-73.4））。有吞咽困难和营养不良的患者院内、6个月和1年死亡率增加（P < 0.05）。最差的结果是两种情况下的患者（1年死亡率为65.8%）。结论：吞咽困难的患病率高于营养不良在我们的老年患者。吞咽困难是营养不良的独立危险因素，两种情况均与不良结局相关。(C)2014爱思唯尔有限公司和欧洲临床营养与代谢学会。All rights reserved.
Background Ea aims: Oropharyngeal dysphagia and malnutrition are prevalent conditions in the older. The aim of this study was to explore the relationship between oropharyngeal dysphagia, nutritional status and clinical outcome in older patients admitted to an acute geriatric unit.Methods: We studied 1662 patients >= 70 years consecutively hospitalized with acute diseases, in whom dysphagia could be clinically assessed by the volume-viscosity swallow test and nutritional status with the Mini Nutritional Assessment. Anthropometric and laboratory measurements were taken and mortality recorded during hospital stay, at 6 months and one year after discharge was recorded.Results: 47.4% (95% CI 45-49.8%) patients presented oropharyngeal dysphagia and 30.6% (95% CI 27.9% -33.3%), malnutrition. Both conditions were associated with multimorbidity, multiple geriatric syndromes and poor functional capacity (p < 0.001). However, patients with dysphagia presented increased prevalence of malnutrition (MNA (R) < 1745.3% vs 18%, p < 0.001) regardless of their functional status and comorbidities (OR 2.31 (1.70-3.14)) and lower albumin and cholesterol levels. Patients with malnutrition presented an increased prevalence of dysphagia (68.4% (95% CI 63.3-73.4)). Patients with dysphagia and patients with malnutrition presented increased intrahospital, 6-month and 1-year mortality rates (p < 0.05). The poorest outcome was for patients with both conditions (1-year mortality was 65.8%).Conclusions: Prevalence of dysphagia was higher than malnutrition in our older patients. Dysphagia was an independent risk factor for malnufrition, and both conditions were related to poor outcome. (C) 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.