影响肠内营养支持老年患者生存的因素

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-06-29 DOI:10.1111/jep.70168

Tuğba Önder, Çağatay Çavuşoğlu, Ebru Öztürk, Funda Yıldırım Borazan, Berna Göker

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引用次数: 0

摘要

目的临床和实验室特征对接受肠内营养（EN）支持的老年患者生存结局的影响尚不清楚。方法分析临床特征、老年综合评估评分和营养支持使用时间对我院老年门诊接受肠内营养支持的患者生存结局的影响。结果共分析339例患者，其中女性211例，占62.2%。中位年龄为81岁（范围：65 ~ 102岁）。口服营养支持321例（94.7%），经皮内镜胃造口术（PEG）给予营养支持18例（5.3%）。MNA-SF、ADLs、IADL、MMTs和GDS-SF评分的中位数分别为8（1−14）、5（0−6）、4（0−8）、22（0−30）和5（0−15）。男性(HR = 2.403, 95% CI = 1.355−4.273；P = 0.003)，老年[75 ~ 84岁vs. 65 ~ 74岁；Hr = 2.960, 95% ci = 1.010-8.677；P = 0.048, >； 85 vs 65 - 74岁；Hr = 5.504, 95% ci = 1.854−16.335；p = 0.002),更高的LDH (HR = 1.004, 95% CI = 1.002−1.006;p & lt; 0.001),降低IADL评分(HR = 1.215, 95% CI = 1.102 - -1.336;p < 0.001)和更短的ENS持续时间(HR = 1.269, 95% CI = 1.122−1.436；P < 0.001)与较差的生存率相关。肠内喂养时间每缩短1个月，第5个月死亡风险增加1.215倍，第10个月死亡风险增加1.171倍；这种影响随着时间的推移而减弱。通过PEG进行营养支持的患者中位生存期为12±2.9个月（范围6.2 - 17.7个月）。PEG组1年生存率为50%，3年生存率为12%。ONS组1年生存率为78%，3年生存率为55%。我们的研究结果表明，男性、年龄较大、高LDH水平、低IADL评分和较短的ENS持续时间可能与接受EN支持的老年患者的不良生存结局相关。

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Factors Affecting Survival in Older Patients on Enteral Nutritional Support

Aims

The effects of clinical and laboratory characteristics on survival outcomes in older patients receiving enteral nutrition (EN) support are unclear.

Methods

We analysed the effects of clinical characteristics, comprehensive geriatric assessment scores and duration of nutritional support use on the survival outcomes of older patients who received enteral nutritional support in our Geriatrics Clinic.

Results

Three hundred and thirty-nine patients were analysed, of whom 211 (62.2%) were female. The median age was 81 years (range: 65−102). Oral nutritional support was given to 321 (94.7%) patients, and 18 (5.3%) were given nutritional support via percutaneous endoscopic gastrostomy (PEG). The median MNA-SF, ADLs, IADL, MMTs and GDS-SF scores were 8 (1−14), 5 (0−6), 4 (0−8), 22 (0−30) and 5 (0−15), respectively. Male sex (HR = 2.403, 95% CI = 1.355−4.273; p = 0.003), older age [75−84 vs. 65−74 years; HR = 2.960, 95% CI = 1.010–8.677; p = 0.048 and > 85 versus 65−74 years; HR = 5.504, 95% CI = 1.854−16.335; p = 0.002], higher LDH (HR = 1.004, 95% CI = 1.002−1.006; p < 0.001), lower IADL score (HR = 1.215, 95% CI = 1.102–1.336; p < 0.001) and shorter ENS duration (HR = 1.269, 95% CI = 1.122−1.436; p < 0.001) were associated with worse survival. With a 1-month reduction in the enteral feeding period, the risk of death in the 5th month increased by 1.215 times, and the risk of death in the 10th month increased by 1.171 times; this effect diminished over time. The median survival of patients on nutritional support via PEG was 12 ± 2.9 months (range 6.2−17.7). The 1-year survival rate in the PEG group was 50%, and the 3-year survival rate was 12%. In the ONS group, the 1-year survival rate was 78%, and the 3-year survival rate was 55%.

Conclusions

Our results suggest that male sex, older age, high LDH levels, low IADL scores and shorter ENS duration may be associated with adverse survival outcomes in older patients receiving EN support.

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.