A Cohort Study of Subjective Global Assessment and Mortality in Taiwanese Hemodialysis Patients
A Cohort Study of Subjective Global Assessment and Mortality in Taiwanese Hemodialysis Patients
复制标题
台湾血液透析患者主观总体评估和死亡率的队列研究
DOI：
10.1080/08860220701643542
复制
发表时间：
2007
期刊：
影响因子：
3
通讯作者：
B. Hsu
中科院分区：
文献类型：
--
作者：
Fwu;Ru;Chih;T. Fang;B. Hsu
许多终末期肾病患者营养不良，横断面研究表明，营养不良的标志物可以预测死亡。在这项研究中，我们调查了一个小型台湾血液透析患者队列的主观总体评估和死亡率的可能关联。本研究于2002年6月在台湾东部一家血液透析中心招募了50名血液透析患者。身高和体重被用来确定体重指数。在周中透析治疗前后进行体脂量的生物电阻抗分析。营养状况的生化指标包括血清白蛋白、肌酐、转铁蛋白、胆固醇和标准化蛋白分解率。获得入组后42个月内的死亡率数据。根据主观全面评估，26名血液透析患者被归类为营养良好，24名营养不良。营养不良组的体重指数降低（p = 0.006）、体脂量增加（血液透析前p = 0.019;血液透析后p = 0.007）、血清白蛋白降低（p = 0.011）和血清肌酐降低（p = 0.006）显著更高。高龄（p = 0.042）、血清白蛋白降低（p = 0.028）、血清转铁蛋白降低（p = 0.041）和营养不良（p = 0.004）在死亡组中显著较高。多变量前向逐步线性回归分析的死亡率和营养概况显示，主观全面评估是死亡率的独立预测因子（R2 = 0.20）。在台湾，营养不良的血液透析患者的死亡率高于营养良好的血液透析患者。营养状况的主观总体评估似乎是评估长期护理血液透析患者营养状况的简单工具。这种评估工具也有利于营养相关死亡风险较高的血液透析患者。
Many patients with end-stage renal disease are malnourished, and cross-sectional studies have shown that markers of malnutrition may predict death. In this study, we investigated the possible association of Subjective Global Assessment and mortality in a small cohort of Taiwanese hemodialysis patients. Fifty hemodialysis patients at a hemodialysis center in eastern Taiwan were enrolled in June 2002. Height and weight were used to determine the body mass index. Bioelectrical impedance analysis of body fat mass was performed before and after a mid-week dialysis session. Biochemical indexes of the nutritional status included serum albumin, creatinine, transferrin, cholesterol, and the normalized protein catabolic rate. Mortality data during 42 months after enrollment were obtained. Twenty-six hemodialysis patients were classified as well-nourished and twenty-four as malnourished based on Subjective Global Assessment. Decreased body mass index (p = 0.006), increased body fat mass (p = 0.019 before hemodialysis; p = 0.007 after hemodialysis), decreased serum albumin (p = 0.011), and decreased serum creatinine (p = 0.006) were significantly higher in the malnourished group. Older age (p = 0.042), decreased serum albumin (p = 0.028), decreased serum transferrin (p = 0.041), and malnourishment (p = 0.004) were significantly higher in the mortality group. Multivariate forward stepwise linear regression analysis of mortality and nutrition profiles show that Subjective Global Assessment is the independent predictor of mortality (R2 = 0.20). Malnourished hemodialysis patients had a higher mortality rate than well-nourished hemodialysis patients in Taiwan. Subjective Global Assessment of the nutritional status appears to be a simple tool for assessing the nutritional status of hemodialysis patients in long-term care. This assessment tool is also beneficial for hemodialysis patients who are at a greater risk of nutritional-associated mortality.
影响因子：
13.2
作者：
Kalantar-Zadeh, K;Kopple, JD;Humphreys, MH
通讯作者：
Humphreys, MH
影响因子：
19.6
作者：
Ikizler, TA;Wingard, RL;Hakim, RM
通讯作者：
Hakim, RM