根据GLIM标准对老年住院患者进行营养支持的效果评价

IF 4 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging Pub Date : 2025-05-23 DOI:10.1016/j.jnha.2025.100585

Shan Jiang , Xiling Chen , Lan Ma , Qihao Guo , Lan Luo , Yuehui Wang , Xuan Qu , Jiaojiao Li , Liping An , Wei Huang , Yonghua Wu , Hongyu Zhang , Cuntai Zhang , Yun Fan , Songbai Zheng , Jian Cao , Xiaohong Liu

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引用次数: 0

摘要

在本研究中，我们旨在探讨营养治疗对根据全球营养不良领导倡议（GLIM）标准分类的患者临床结果的影响。前瞻性、多中心队列研究。本研究于2020年9月至2022年12月在中国28个老年中心进行。参与者：共纳入862例年龄≥65岁的患者。干预：所有参与研究的医生在研究前都按照国际指导原则完成了为期6小时的营养支持培训。患者入院48小时内营养风险筛查2002评分≥3分。医生确定了具体的营养支持方案。测量方法入组后进行glim评估。在基线和入院后90天评估营养和功能状态。临床结果——死亡率、再入院、新感染和跌倒——在90天后记录下来。结果根据GLIM标准，与108例没有营养不良的患者相比，754例营养不良患者的体重、体重指数（BMI）和迷你营养评估-简短形式（MNA-SF）评分较低，握力、小腿围和Barthel日常生活活动（ADLs）指数显著降低。随访90天，营养不良组和非营养不良组患者热量摄入充足的比例分别为70.7% （n = 533）和67.6% (n = 73) (p = 0.51)，蛋白质摄入充足的比例分别为65.9% （n = 497）和58.3% (n = 63) （p = 0.12）。此外，与没有营养不良的患者相比，营养不良患者的体重、BMI、MNA-SF评分、小腿围和Barthel ADL指数均有显著改善。营养不良患者在随访中再次入院和跌倒的风险也较低。结论在有营养风险的老年住院患者中，根据GLIM标准分类的营养不良患者受益于营养支持，表现出BMI、MNA-SF评分、小腿围和Barthel ADL指数的改善，再入院率和跌倒发生率降低。

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Evaluating the effect of nutritional support in geriatric inpatients classified by the GLIM criteria

Objectives

In this study, we aimed to explore the impact of nutrition therapy on clinical outcomes for patients classified according to the Global Leadership Initiative on Malnutrition (GLIM) criteria.

Design

Prospective, multicenter cohort study.

Setting

This study was conducted from September 2020 to December 2022 across 28 geriatric centers in China.

Participants

A total of 862 patients aged ≥65 years were included.

Intervention

All participating physicians completed a 6-h training on nutritional support, following international guidelines before the study. Patients had a nutritional risk screening 2002 score ≥3 points within 48 h of admission. Physicians determined specific nutritional support regimens.

Measurements

GLIM assessments were conducted after enrollment. Nutritional and functional statuses were evaluated at baseline and 90 days after admission. Clinical outcomes—mortality, readmission, new infections, and falls—were documented after 90 days.

Results

Compared to 108 patients without malnutrition per the GLIM criteria, 754 malnourished patients showed lower weight, body mass index (BMI), and Mini Nutritional Assessment-Short Form (MNA-SF) scores and significant reductions in grip strength, calf circumference, and Barthel activities of daily living (ADLs) index. The percentage of patients with adequate caloric intake at the 90-day follow-up was 70.7% (n = 533) and 67.6% (n = 73) in the malnutrition and non-malnutrition groups (p = 0.51) and that of patients with adequate protein intake was 65.9% (n = 497) and 58.3% (n = 63), respectively (p = 0.12). Moreover, malnourished patients showed significant improvements in body weight, BMI, MNA-SF scores, calf circumference, and Barthel ADL index compared to those without malnutrition. Malnourished patients also had lower risks of readmission and falls at follow-up.

Conclusion

Among older inpatients at nutritional risk, those with malnutrition classified according to the GLIM criteria benefited from nutritional support, demonstrating improved BMI, MNA-SF scores, calf circumference, and Barthel ADL index, as well as reduced readmission rates and incidence of falls.

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.