{"title":"住院康复患者的基线营养状况和康复进展：回顾性队列研究","authors":"Hideki Arai MD, PhD , Syuya Okada PT , Tatsuyuki Fukuoka SLP, PhD , Masafumi Nozoe PT, PhD , Kuniyasu Kamiya PT, PhD , Satoru Matsumoto MD","doi":"10.1016/j.arrct.2024.100362","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the relationships between baseline nutritional status, medical events (MEs), and rehabilitation outcomes in individuals undergoing inpatient rehabilitation (IR).</p></div><div><h3>Design</h3><p>A retrospective single center cohort study.</p></div><div><h3>Setting</h3><p>An IR ward.</p></div><div><h3>Participants</h3><p>This study included 409 patients (mean age, 80 years; men, 170 [42%]) undergoing IR for hospital-associated deconditioning, neurologic disorders, or musculoskeletal diseases. Participants were grouped according to the Controlling Nutritional Status score at admission: normal nutrition (NN): 0 to 1, mild malnutrition (MM): 2 to 4, and moderate/severe malnutrition (M/SM): 5 to 12.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Main Outcome Measures</h3><p>The primary outcomes included MEs leading to death or acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were the rehabilitation efficiency scores (changes in Functional Independence Measure [FIM] score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).</p></div><div><h3>Results</h3><p>Among the 409 participants, 300 (73%) were malnourished at admission. The adjusted hazard ratios (95% confidence interval) for MEs in the MM and M/SM groups relative to the NN group were 1.48 (0.67-3.27) and 0.98 (0.34-2.81), respectively. No significant differences were observed among the 3 groups in FIM-M efficiency scores (mean ± SD, NN: 0.49±0.51 vs MM: 0.41±0.57 vs M/SM: 0.44±1.06, <em>P</em>=.7) or FIM-C efficiency scores (0.04±0.06 vs 0.04±0.06 vs 0.08±0.4, <em>P</em>=0.1). Analysis of covariance showed no significant association between MM or M/SM group and FIM-M efficiency score (beta coefficient = -0.038, <em>P</em>=.6; beta coefficient = 0.15, <em>P</em>=.1, respectively) or FIM-C efficiency score (<em>beta coefficient</em> = 0.004, <em>P</em>=.8; <em>beta coefficient</em> = 0.047, <em>P</em>=.08, respectively).</p></div><div><h3>Conclusion</h3><p>No significant associations were observed between the baseline nutritional status and MEs, FIM-M efficiency score, or FIM-C efficiency score in individuals undergoing IR.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100362"},"PeriodicalIF":1.9000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000600/pdfft?md5=127a5be27861074f2c6a02c49b209b50&pid=1-s2.0-S2590109524000600-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Baseline Nutritional Status and Rehabilitation Progress in Individuals Requiring Inpatient Rehabilitation: A Retrospective Cohort Study\",\"authors\":\"Hideki Arai MD, PhD , Syuya Okada PT , Tatsuyuki Fukuoka SLP, PhD , Masafumi Nozoe PT, PhD , Kuniyasu Kamiya PT, PhD , Satoru Matsumoto MD\",\"doi\":\"10.1016/j.arrct.2024.100362\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To evaluate the relationships between baseline nutritional status, medical events (MEs), and rehabilitation outcomes in individuals undergoing inpatient rehabilitation (IR).</p></div><div><h3>Design</h3><p>A retrospective single center cohort study.</p></div><div><h3>Setting</h3><p>An IR ward.</p></div><div><h3>Participants</h3><p>This study included 409 patients (mean age, 80 years; men, 170 [42%]) undergoing IR for hospital-associated deconditioning, neurologic disorders, or musculoskeletal diseases. Participants were grouped according to the Controlling Nutritional Status score at admission: normal nutrition (NN): 0 to 1, mild malnutrition (MM): 2 to 4, and moderate/severe malnutrition (M/SM): 5 to 12.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Main Outcome Measures</h3><p>The primary outcomes included MEs leading to death or acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were the rehabilitation efficiency scores (changes in Functional Independence Measure [FIM] score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).</p></div><div><h3>Results</h3><p>Among the 409 participants, 300 (73%) were malnourished at admission. The adjusted hazard ratios (95% confidence interval) for MEs in the MM and M/SM groups relative to the NN group were 1.48 (0.67-3.27) and 0.98 (0.34-2.81), respectively. No significant differences were observed among the 3 groups in FIM-M efficiency scores (mean ± SD, NN: 0.49±0.51 vs MM: 0.41±0.57 vs M/SM: 0.44±1.06, <em>P</em>=.7) or FIM-C efficiency scores (0.04±0.06 vs 0.04±0.06 vs 0.08±0.4, <em>P</em>=0.1). Analysis of covariance showed no significant association between MM or M/SM group and FIM-M efficiency score (beta coefficient = -0.038, <em>P</em>=.6; beta coefficient = 0.15, <em>P</em>=.1, respectively) or FIM-C efficiency score (<em>beta coefficient</em> = 0.004, <em>P</em>=.8; <em>beta coefficient</em> = 0.047, <em>P</em>=.08, respectively).</p></div><div><h3>Conclusion</h3><p>No significant associations were observed between the baseline nutritional status and MEs, FIM-M efficiency score, or FIM-C efficiency score in individuals undergoing IR.</p></div>\",\"PeriodicalId\":72291,\"journal\":{\"name\":\"Archives of rehabilitation research and clinical translation\",\"volume\":\"6 3\",\"pages\":\"Article 100362\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2590109524000600/pdfft?md5=127a5be27861074f2c6a02c49b209b50&pid=1-s2.0-S2590109524000600-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of rehabilitation research and clinical translation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2590109524000600\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of rehabilitation research and clinical translation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590109524000600","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
摘要
目的评估住院康复（IR）患者的基线营养状况、医疗事件（ME）和康复效果之间的关系。干预措施无。主要结果测量主要结果包括导致死亡的 ME 或需要转院接受专门治疗的急性病。次要结果为运动功能（FIM-M）和认知功能（FIM-C）的康复效率评分（功能独立性测量[FIM]评分变化除以住院时间）。MM组和M/SM组相对于NN组的ME调整后危险比（95%置信区间）分别为1.48（0.67-3.27）和0.98（0.34-2.81）。三组间的 FIM-M 效率评分（平均值 ± SD，NN：0.49±0.51 vs MM：0.41±0.57 vs M/SM：0.44±1.06，P=0.7）或 FIM-C 效率评分（0.04±0.06 vs 0.04±0.06 vs 0.08±0.4，P=0.1）无明显差异。协方差分析表明，MM 或 M/SM 组与 FIM-M 效率评分（贝塔系数 = -0.038，P=.6；贝塔系数 = 0.15，P=.1）或 FIM-C 效率评分（贝塔系数 = 0.结论 在接受 IR 治疗的患者中，未观察到基线营养状况与 MEs、FIM-M 效率评分或 FIM-C 效率评分之间存在显著关联。
Baseline Nutritional Status and Rehabilitation Progress in Individuals Requiring Inpatient Rehabilitation: A Retrospective Cohort Study
Objective
To evaluate the relationships between baseline nutritional status, medical events (MEs), and rehabilitation outcomes in individuals undergoing inpatient rehabilitation (IR).
Design
A retrospective single center cohort study.
Setting
An IR ward.
Participants
This study included 409 patients (mean age, 80 years; men, 170 [42%]) undergoing IR for hospital-associated deconditioning, neurologic disorders, or musculoskeletal diseases. Participants were grouped according to the Controlling Nutritional Status score at admission: normal nutrition (NN): 0 to 1, mild malnutrition (MM): 2 to 4, and moderate/severe malnutrition (M/SM): 5 to 12.
Interventions
None.
Main Outcome Measures
The primary outcomes included MEs leading to death or acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were the rehabilitation efficiency scores (changes in Functional Independence Measure [FIM] score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).
Results
Among the 409 participants, 300 (73%) were malnourished at admission. The adjusted hazard ratios (95% confidence interval) for MEs in the MM and M/SM groups relative to the NN group were 1.48 (0.67-3.27) and 0.98 (0.34-2.81), respectively. No significant differences were observed among the 3 groups in FIM-M efficiency scores (mean ± SD, NN: 0.49±0.51 vs MM: 0.41±0.57 vs M/SM: 0.44±1.06, P=.7) or FIM-C efficiency scores (0.04±0.06 vs 0.04±0.06 vs 0.08±0.4, P=0.1). Analysis of covariance showed no significant association between MM or M/SM group and FIM-M efficiency score (beta coefficient = -0.038, P=.6; beta coefficient = 0.15, P=.1, respectively) or FIM-C efficiency score (beta coefficient = 0.004, P=.8; beta coefficient = 0.047, P=.08, respectively).
Conclusion
No significant associations were observed between the baseline nutritional status and MEs, FIM-M efficiency score, or FIM-C efficiency score in individuals undergoing IR.
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