微型營養評估簡易法預測老年住院患者臨床預后的研究_《華西醫學》

作者：

蒲虹杉 , 趙冬青 , 董碧蓉

四川大學華西醫院老年科（成都, 610041）;

關鍵詞：

微型營養評估簡易法營養不良老年預后

DOI：

10.7507/1002-0179.20130280

視頻：

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目的　探索微型營養評估簡易法（MNA-SF）能否客觀、正確地評估老年住院患者的營養狀況以及對臨床預后進行預測。方法　選擇2012年3月－4月四川大學華西醫院新入院老年患者407例，平均年齡（75.4 ± 7.10）歲，以MNA-SF評估其營養狀態并根據營養狀態分為兩組，隨訪至出院或住院第30 d，分析其營養狀況與住院時間，住院費用，全身炎癥反應綜合征（SIRS），死亡等臨床結局的相關性。結果　營養不良者22.6%（92例），營養不良風險者31.9%（130例），營養狀態良好者45.5%（185例）。其中34例營養不良者，18例營養不良風險者和4例營養良好者發生SIRS；另有11例營養不良者，7例營養不良風險者和1例營養良好者死亡。MNA-SF分值在0～7分的患者無論在發生SIRS還是臨床不良結局方面顯著高于分值為8～14分的患者（P＜0.05）。營養不良者住院時間為（14.6 ± 8.30）d，營養不良風險或營養良好者為（12.1 ± 7.99）d，差異具有統計學意義（P＜0.05）。結論　 MNA-SF是一可靠，簡便易行，可以預測老年住院患者臨床預后的營養評估工具。

引用本文： 蒲虹杉,趙冬青,董碧蓉. 微型營養評估簡易法預測老年住院患者臨床預后的研究. 華西醫學, 2013, 28(6): 898-901. doi: 10.7507/1002-0179.20130280 復制

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2.	Feldblum I, German L, Caste H, et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status[J]. Nutr J, 2007, 37(6): 1-9.
3.	De Luis DA, López Mongil R, González Sagrado M, et al. Evaluation of the mini-nutritional assessment short-form(MNA-SF) among institutionalized older patients in Spain. Nutrición hospitalaria [J]. 2011, 26(6): 1350-1354.
4.	Rubenstein LZ, Harker JO, Salva A, et al. Screening for under nutrition in geriatric practice: Developing the short form Mini-Nutrtional Assessment(MNA-SF)[J]. J Gerontol, 2001, 56(6): M366-372.
5.	Kondrup J, Allison SP, Elia M, et al. ESPEN Guidelines for Nutrition Screening 2002 [J]. Clinical Nutrition, 2003(22): 415-421.
6.	Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status[J]. J Nutr Health Aging, 2009, 13(9): 782-788.
7.	劉學員, 唐偉雄, 唐慧明, 等. MNA、MNA-SF 在老年患者營養評價中的應用[J].解放軍醫學雜志, 2008, 33(2): 237.
8.	汪海峰. 老年惡性腫瘤患者MNA-SF營養評價和SF-36生活質量評價[J]. 同濟大學學報, 2009, 30(3): 129-131.
9.	何文英, 張曉斌, 魏喜玲, 等. MNA在炎癥性腸病患者營養評價中的應用[J].河北醫藥, 2010, 32(21): 2977-2979.
10.	Barker LA, Gout BS, Crowe TC. Hospital malnutrition: prevalence, identification and impact on patients and the healthcare system[J]. Int J Environ Res Public Health, 2011, 8(2): 514-527.
11.	Al Snih S, Markides KS, Ottenbacher KJ. Raji MA;Hand grip strength and incident ADL disability in elderly Mexican Americans over a seven-year period[J]. Aging clinical and experimental research, 2004, 16(6):481-486.
12.	徐盛明, 劉明媛, 李保春.全身炎癥反應綜合征和多器官功能障礙綜合征的治療進展[J].第二軍醫大學學報, 2004, 25(8): 886-888.
13.	齊文杰, 張淑文. 全身炎癥反應綜合征評分在急性感染患者預后中的價值[J]. 臨床和實驗醫學雜志, 2002, 1(2): 76-79.
14.	Braunschweig C, Gomez S, Sheean PM. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days [J]. J Am Diet Assoc, 2000, 100(11): 1316-1322.
15.	Middleton MH, Nazarenko G, Nivison-Smith I, et al. Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals [J]. Int Med J, 2001, 31(8): 455-61.
16.	Isabel TD, Correia M. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis [J]. Clin Nutr, 2003, 22(3): 235-239.
17.	Stratton RJ, King CL, Stroud MA, et al. “Malnutrition Universal Screening Tool” predicts mortality and length of hospital stay in acutely ill elderly [J]. Br J Nutr, 2006, 95(2): 325-330.

1. 　Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition[J]. Clin Geriatr Med, 2002, 18(4): 737-757.
2. 　Feldblum I, German L, Caste H, et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status[J]. Nutr J, 2007, 37(6): 1-9.
3. 　De Luis DA, López Mongil R, González Sagrado M, et al. Evaluation of the mini-nutritional assessment short-form(MNA-SF) among institutionalized older patients in Spain. Nutrición hospitalaria [J]. 2011, 26(6): 1350-1354.
4. 　Rubenstein LZ, Harker JO, Salva A, et al. Screening for under nutrition in geriatric practice: Developing the short form Mini-Nutrtional Assessment(MNA-SF)[J]. J Gerontol, 2001, 56(6): M366-372.
5. 　Kondrup J, Allison SP, Elia M, et al. ESPEN Guidelines for Nutrition Screening 2002 [J]. Clinical Nutrition, 2003(22): 415-421.
6. 　Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status[J]. J Nutr Health Aging, 2009, 13(9): 782-788.
7. 　劉學員, 唐偉雄, 唐慧明, 等. MNA、MNA-SF 在老年患者營養評價中的應用[J].解放軍醫學雜志, 2008, 33(2): 237.
8. 　汪海峰. 老年惡性腫瘤患者MNA-SF營養評價和SF-36生活質量評價[J]. 同濟大學學報, 2009, 30(3): 129-131.
9. 　何文英, 張曉斌, 魏喜玲, 等. MNA在炎癥性腸病患者營養評價中的應用[J].河北醫藥, 2010, 32(21): 2977-2979.
10. 　Barker LA, Gout BS, Crowe TC. Hospital malnutrition: prevalence, identification and impact on patients and the healthcare system[J]. Int J Environ Res Public Health, 2011, 8(2): 514-527.
11. 　Al Snih S, Markides KS, Ottenbacher KJ. Raji MA;Hand grip strength and incident ADL disability in elderly Mexican Americans over a seven-year period[J]. Aging clinical and experimental research, 2004, 16(6):481-486.
12. 　徐盛明, 劉明媛, 李保春.全身炎癥反應綜合征和多器官功能障礙綜合征的治療進展[J].第二軍醫大學學報, 2004, 25(8): 886-888.
13. 　齊文杰, 張淑文. 全身炎癥反應綜合征評分在急性感染患者預后中的價值[J]. 臨床和實驗醫學雜志, 2002, 1(2): 76-79.
14. 　Braunschweig C, Gomez S, Sheean PM. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days [J]. J Am Diet Assoc, 2000, 100(11): 1316-1322.
15. 　Middleton MH, Nazarenko G, Nivison-Smith I, et al. Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals [J]. Int Med J, 2001, 31(8): 455-61.
16. 　Isabel TD, Correia M. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis [J]. Clin Nutr, 2003, 22(3): 235-239.
17. 　Stratton RJ, King CL, Stroud MA, et al. “Malnutrition Universal Screening Tool” predicts mortality and length of hospital stay in acutely ill elderly [J]. Br J Nutr, 2006, 95(2): 325-330.

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微型營養評估簡易法預測老年住院患者臨床預后的研究

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微型營養評估簡易法預測老年住院患者臨床預后的研究

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