CAJ | 학술논문

目的：探讨老年科住院患者营养状态与临床结局的关系。方法入选98例2011年11月至2012年3月在中国医学科学院北京协和医院老年科住院的≥60岁的患者进行前瞻性调查。入院72h内完成实验室指标、微型营养评估简表（MNA-SF）、膳食回顾、人体测量和体成分分析等营养评定，观察临床结局（死亡、并发症及总住院时间等）。结果98例患者均全部完成了整个调查，年龄（74.06±7.90）岁。MNA-SF结果正常营养状态者40例（40.82%），营养不良危险37例（37.76%），营养不良21例（21.43%）。营养不良者年龄（79.1±9.3）岁，明显高于其余两组（均P＜0.05）。营养不良者前白蛋白[（114.7±62.5）mg/L，n＝19]水平明显低于营养正常组[（204.0±65.2）mg/L， n＝37，P＜0.05]和营养不良危险组[（175.1±58.3）mg/L，n＝34，P＜0.05]。营养不良组感染并发症（28.6%）明显高于营养正常组（12.5%）和营养不良危险组（5.4%）。营养不良组的平均住院时间[（21.9±8.9）d]均高于营养正常组[（14.9±5.9）d]和营养不良危险组[（15.9±7.5）d，均P＜0.05）]。所有患者死亡2例，均发生在营养不良组。结论住院老年患者，营养不良及营养不良危险的发生率较高。营养不良延长住院老年患者的住院时间，增加感染并发症，甚至可能增加死亡风险。
목적：탐토노년과주원환자영양상태여림상결국적관계。방법입선98례2011년11월지2012년3월재중국의학과학원북경협화의원노년과주원적≥60세적환자진행전첨성조사。입원72h내완성실험실지표、미형영양평고간표（MNA-SF）、선식회고、인체측량화체성분분석등영양평정，관찰림상결국（사망、병발증급총주원시간등）。결과98례환자균전부완성료정개조사，년령（74.06±7.90）세。MNA-SF결과정상영양상태자40례（40.82%），영양불량위험37례（37.76%），영양불량21례（21.43%）。영양불량자년령（79.1±9.3）세，명현고우기여량조（균P＜0.05）。영양불량자전백단백[（114.7±62.5）mg/L，n＝19]수평명현저우영양정상조[（204.0±65.2）mg/L， n＝37，P＜0.05]화영양불량위험조[（175.1±58.3）mg/L，n＝34，P＜0.05]。영양불량조감염병발증（28.6%）명현고우영양정상조（12.5%）화영양불량위험조（5.4%）。영양불량조적평균주원시간[（21.9±8.9）d]균고우영양정상조[（14.9±5.9）d]화영양불량위험조[（15.9±7.5）d，균P＜0.05）]。소유환자사망2례，균발생재영양불량조。결론주원노년환자，영양불량급영양불량위험적발생솔교고。영양불량연장주원노년환자적주원시간，증가감염병발증，심지가능증가사망풍험。
Objective To investigate the relationship between nutrition status in the elderly inpatients admitted in Geriatric Department and their clinical outcomes. Methods A total of 98 inpatients aged over 60 years from the Geriatric Department of Peking Union Medical College Hospital from November 2011 to March 2012 were enrolled in this study. All the patients were assessed with the Mini Nutritional Assessment Short-Form (MNA-SF) within 72h after admission. At the same period, their anthropometric indices, dietary recall, laboratory indices, and human body composition were also obtained. Clinical outcomes including death, complications, and length of stay (LOS) were observed. Results All enrolled participants completed the entire study. They were at an age of (74.06±7.90) years. MNA-SF indicated that 40 cases (40.82%) were rated as Normalized (MNA-N), 37 cases (37.76%) at Malnutrition Risk (MNA-MR), and 21 cases (21.43%) Malnutrition (MNA-M). The patients in MNA-M [(79.1±9.3) years] were significantly elder than those in MNA-N (both P<0.05). Serum content of pre-albumin was significantly lower in MNA-M patients [(114.7±62.5)mg/L, n=19] than MNA-N [(204.0±65.2)mg/L, n=37] and MNA-MR patients [(175.1±58.3)mg/L, n=34, both P<0.05]. The incidences of infectious complications were obviously higher in MNA-M patients (28.6%) than MNA-N (12.5%) and MNA-MR patients (5.4%). Moreover, LOS in MNA-M patients [(21.9±8.9)d] was much longer than that in MNA-N [(14.9±5.9)d] and MNA-MR [(15.9±7.5)d, both P<0.05)]. There were 2 patients died, both in MNA-M. Conclusion The Elderly inpatients from Geriatric Department are more common in <br> malnutrition or at risk of malnutrition. Malnutrition will obviously prolong their LOS, and increase the incidences of infectious complications, and even mortality risk.