Hospital malnutrition screening at admission: malnutrition increases mortality and length of stay
Hospital malnutrition screening at admission: malnutrition increases mortality and length of stay
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DOI：
10.20960/nh.657
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发表时间：
2017-08-01
期刊：
影响因子：
--
通讯作者：
Llop Talaveron, Josep Manel
中科院分区：
文献类型：
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作者：
Leiva Badosam, Elisabet;Badia Tahull, María;Llop Talaveron, Josep Manel
前言：营养不良在住院患者中很常见，并与发病率和死亡率相关。我们进行了一项研究，以评估营养风险的患病率，相关的危险因素及其后果在三级hospital.Methods：这是一个前瞻性的营养筛查研究的住院患者在入院后的第一个72小时内进行评估，营养不良通用筛查工具（MUST）和简短的营养评估问卷（SNAQ）筛选测试。结果：在409名患者中，根据MUST和SNAQ，分别有12.7%和15.3%的患者存在营养风险，其中重症监护病房的患病率最高（33.3%; 25.5%），肿瘤患者（17.5%; 28.4%）和那些具有较高的Charlson合并症指数（CCI）。严重营养不良风险患者的住院时间（LOS）较长（MUST为15.4 vs 9.9天; SNAQ为13.3 vs 9.9天）。营养不良风险高的患者死亡率更高（MUST为66.7% vs 10.9%; SNAQ为50.0% vs 14.2%）。多因素分析显示营养不良与CCI和死亡率相关。与LOS相关的风险因素入院为紧急情况下，MUST和SNAQ tests.Conclusions：营养不良的患病率是高的患者入院到三级医院，在重症监护病房，肿瘤患者和那些有较高的CCI之间的患病率较高。营养不良与更长的LOS和更高的死亡率相关。系统地临床使用筛查工具能够发现有营养不良风险的患者并采取适当行动。
Introduction: Malnutrition is common in patients admitted to hospital and is associated with morbidity and mortality. We conducted a study to assess the prevalence of nutritional risk, risk factors associated and its consequences in a third-level hospital.Methods: This is a prospective nutritional screening study of hospitalized patients evaluated within the first 72 hours of admission, by Malnutrition Universal Screening Tool (MUST) and Short Nutritional Assessment Questionnaire (SNAQ) screening tests. The variables recorded included demographic, anthropometric, hospitalization and clinical data.Results: Out of 409 patients, 12.7% and 15.3% were nutritionally at risk according to MUST and SNAQ, respectively, with the highest prevalence in critical care units (33.3%; 25.5%), amongst oncologic patients (17.5%; 28.4%) and those with higher Charlson comorbidity indices (CCI). Length of stay (LOS) was longer in patients at severe malnutrition risk (15.4 vs 9.9 days for MUST; 13.3 vs 9.9 days for SNAQ). Mortality was higher in those with high malnutrition risk (66.7% vs 10.9% for MUST; 50.0% vs 14.2% for SNAQ). Multivariate analysis showed that malnutrition was associated with CCI and mortality. Risk factors associated with LOS were admission as emergencies for both MUST and SNAQ tests.Conclusions: The prevalence of malnutrition is high in patients on admission to a third-level hospital, with a higher prevalence in critical care units, amongst oncologic patients and those with a higher CCI. Malnutrition is associated with longer LOS and higher mortality. The systematic clinical use of screening tools enables to detect patients at risk of malnutrition and take appropriate action.