成人住院患者的营养不良及其对住院时间的影响，一项为期10年的重复横断面研究，分析了65226次住院。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-04-04 DOI:10.1016/j.clnesp.2025.04.001

Thierry Chevalier , Josiane Arnaud , Jérôme Fauconnier , Eric Fontaine

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引用次数: 0

摘要

背景与目的：住院患者营养不良的发生率及其对住院时间（LOS）的影响因所研究的人群、诊断标准或使用的筛查工具而有很大差异。以前的报告使用的是控制数据，研究对象是小群体，而大群体研究的是未经证实的声明性数据。本研究旨在利用经验证的人体测量数据确定大量人口中营养不良的普遍程度，并评估其对LOS的影响。方法：- 10年来（2007-2017年），一个专门的营养评估单位对一家三级医院的住院患者进行营养不良筛查，但急诊和重症监护、骨科、儿科和产科病房除外。在每个单元内，每两到三周进行一次筛查。成年住院患者的营养不良诊断采用体重指数（BMI）（2岁< 18.5 kg/m2，年龄≥70岁）或体重下降（1个月体重下降>5%或6个月体重下降>10%）。我们回顾性分析了该数据库，观察了所有住院至少一天的成年人（18岁至18岁）。分析了营养不良的流行程度及其对LOS的影响，对整个人口以及按性别、年龄组和诊断相关组（DRGs）进行了分析。统计学采用卡方检验、t检验、方差分析和混合线性分析。年龄和性别是潜在的混杂因素，而DRG是随机效应。结果：分析包括65,226例住院患者的数据。平均年龄65岁（最小18岁，最大113岁），58.2%为男性。营养不良的总体发生率为29.77%，40至70岁年龄组的营养不良发生率低于年轻和老年人群。在接受调查的53个发展中国家中，营养不良的发生率从12%到57.89%不等。在总体人群中，营养不良患者的LOS比营养良好的患者更长，中位数增加了5天。在53个发展中国家中，有42个国家（占总人口的97.57%）营养不良显著增加了LOS。结论：这项对住院成人中经证实的人体测量数据诊断出的营养不良患病率的大型研究，并不能证实最近从医院数据库中未经证实的数据中获得的发现。

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Undernutrition in adult hospitalized patients and its impact on the length of stay, a 10-year repeated cross-sectional study analyzing 65,226 stays

Background & aims

The prevalence of undernutrition in hospitalized patients and its impact on their length of stay (LOS) varies considerably depending on the population studied, the diagnosis criteria or the screening tools used. Previous reports using controlled data have been done on small populations while large cohorts have been studied on unverified declarative data. This study aims at determining the prevalence of undernutrition in a large population using verified anthropometric data and assessing its impact on the LOS.

Methods

– For 10 years (2007–2017), a specialized nutritional assessment unit screened inpatients in a tertiary hospital for undernutrition, with the exception of those in emergency and intensive care, orthopedics, pediatrics and maternity wards. Within each unit, screening was carried out every two to three weeks. The diagnosis of undernutrition in adult inpatients was made using body mass index (BMI) (<18.5 kg/m² for age <70 or < 21 kg/m² for age ≥70) or weight loss (weight loss >5 % over a month or >10 % over 6 months). We retrospectively analyzed this database, looking at all adults (>18 years) hospitalized for at least one day. The analysis of the prevalence of undernutrition and its consequence on the LOS was performed on the entire population as well as by sex, age groups and diagnosis-related groups (DRGs). Statistics were performed using the chi-square test, T-test, ANOVA and mixed linear analysis. Age and gender were added as potential confounders, while DRG was included as a random effect.

Results

The analysis included data from 65,226 stays. Mean age 65 years (min 18, max 113), 58.2 % male patients. The overall prevalence of undernutrition was 29.77 %, lower in the 40 to 70-year-old group than in the younger and older population. Undernutrition was present in all of the 53 surveyed DRGs, with a prevalence ranging from 12 % to 57.89 %. In the overall population, undernourished patients had a longer LOS than well-nourished patients, with a median increase of 5 days. In 42 of the 53 DRGs, representing 97.57 % of the total population, undernutrition significantly increased the LOS.

Conclusions

This large study of the prevalence of undernutrition diagnosed from verified anthropometric data in hospitalized adults does not confirm recent findings obtained from unverified data in hospital databases.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.