向有营养不良风险的老年住院患者提供营养支持相关的患者特征：一项队列研究

IF 7.4 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-07-07 DOI:10.1016/j.clnu.2025.07.007

Kristin I. Folven , Randi J. Tangvik , Roy M. Nilsen , Anne Marie Beck , Kari Sygnestveit , Eli Skeie , Øystein Hetlevik , Eva Biringer

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引用次数: 0

摘要

背景和目的有必要了解对有营养不良风险的住院老年患者营养支持的影响因素。我们的目的是调查患者特征是否与有营养不良风险的住院老年患者接受营养支持的可能性相关。方法根据2002年营养风险筛查（NRS 2002），选取2739例年龄≥65岁、存在营养不良风险的躯体患者，其中3188例住院。从2008年至2018年期间的住院点患病率调查中收集了有关营养不良风险、营养支持（菜单修改、口服营养补充剂和肠内或肠外营养）和营养师参与的信息。年龄、性别、诊断和住院类型的信息从电子患者管理系统中检索。我们应用logistic和多项回归模型来研究患者特征（年龄、性别、诊断次数、BMI、住院类型和营养风险筛查评分）与接受任何营养支持和特定类型营养支持的可能性之间的关系。结果56%的住院患者提供营养支持，9%的住院患者计划提供营养支持。7%的住院患者有营养师参与，21%有营养不良风险的患者被诊断为营养不良。与65-69岁的患者相比，老年患者接受任何营养支持的可能性较小（调整OR范围：0.69-0.84）。被归类为体重不足的患者更有可能(调整后的OR (95%CI): 1.77(1.44, 2.17))，而超重和肥胖类别的患者更不可能(调整后的OR （95%CI): 0.70（0.57, 0.87）和0.70(0.52,0.94)）接受营养支持。接受营养支持的OR随着NRS 2002评分的增加而显著增加（调整OR范围：1.79-4.20）。结论：超过三分之一有营养不良风险的老年患者没有在医院接受营养支持，诊断较多的老年患者、体重过轻的老年患者和2002年NRS评分较高的老年患者更经常得到营养支持。研究结果表明，医疗保健专业人员在决定是否为有营养不良风险的老年患者提供营养支持时，在很大程度上受到患者特征的影响。

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Patient characteristics associated with the provision of nutritional support to older hospitalised patients at risk of malnutrition: A cohort study

Background and aims

There is a need for knowledge about the factors affecting nutritional support to hospitalised older patients at risk of malnutrition. We aimed to investigate whether patient characteristics are associated with the likelihood of hospitalised older patients at risk of malnutrition receiving nutritional support.

Methods

The study included 3188 hospital stays among 2739 individual somatic patients aged ≥65 years who were at risk of malnutrition according to the Nutritional Risk Screening 2002 (NRS 2002). Information on the risk of malnutrition, nutritional support (menu modification, oral nutritional supplements and enteral or parenteral nutrition) and dietitian involvement was collected from in-hospital point prevalence surveys between 2008 and 2018. Information on age, sex, diagnoses and type of hospitalisation was retrieved from the electronic patient administration systems. We applied logistic and multinomial regression models to investigate associations of patient characteristics (age, sex, number of diagnoses, BMI, type of hospitalisation and nutritional risk screening score) with the likelihoods of receiving any nutritional support and specific types of nutritional support.

Results

Nutritional support was provided in 56 % and planned in 9 % of hospital stays. Dietitians were involved in 7 % of hospital stays, and 21 % of patients at risk of malnutrition had diagnoses related to malnutrition. Older patients were less likely to have received any nutritional support as compared to the patients 65–69 years old (adjusted OR range: 0.69–0.84). Patients classified as underweight were more likely (adjusted OR (95%CI): 1.77 (1.44, 2.17)) and patients in the overweight and obese categories were less likely (adjusted OR (95%CI): 0.70 (0.57, 0.87) and 0.70 (0.52, 0.94), respectively) to receive nutritional support. The OR for receiving nutritional support substantially increased with increasing NRS 2002 score (adjusted OR range: 1.79–4.20).

Conclusions

This study showed that over one-third of older patients at risk of malnutrition did not receive nutritional support in hospital and that older patients with more diagnoses, those classified as underweight, and those with higher NRS 2002 scores were more frequently provided nutritional support. The findings suggest that healthcare professionals’ decisions regarding whether to provide nutritional support to older patients at risk of malnutrition to a large extent are affected by patient characteristics.

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.