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解放军总医院医学创新研究部、国家老年疾病临床医学研究中心(解放军总医院)、解放军总医院第六医学中心心血管病医学部
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中华老年多器官疾病杂志编辑委员会
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
于凤梅,龚杰,陈郾霖,左思璐,殷杰,胡雯.老年创伤患者营养状况及其影响因素[J].中华老年多器官疾病杂志,2022,21(10):725~730
老年创伤患者营养状况及其影响因素
Nutritional status in elderly trauma patients and its influencing factors
投稿时间:2022-06-08  
DOI:10.11915/j.issn.1671-5403.2022.10.158
中文关键词:  老年人  创伤  营养状况  影响因素
英文关键词:aged  trauma  nutritional status  influencing factor This work was supported by the National Key Research and Development Program of China
基金项目:国家重点研发计划(2018YFC2001804)
作者单位E-mail
于凤梅 四川大学华西医院临床营养科,成都 610041 wendy_nutrition@163.comnutritional 
龚杰 四川大学华西医院临床营养科,成都 610041 wendy_nutrition@163.comnutritional 
陈郾霖 成都中医药大学公共卫生学院,成都611137 wendy_nutrition@163.comnutritional 
左思璐 四川大学华西医院临床营养科,成都 610041 wendy_nutrition@163.comnutritional 
殷杰 四川大学华西医院临床营养科,成都 610041 wendy_nutrition@163.comnutritional 
胡雯 四川大学华西医院临床营养科,成都 610041 wendy_nutrition@163.comnutritional 
摘要点击次数: 60
全文下载次数: 53
中文摘要:
      目的 分析围术期老年创伤患者营养状况及其影响因素,为早期营养干预和临床诊疗提供科学依据,改善其临床结局及预后,提高生活质量。方法 选择四川大学华西医院2021年1月至12月收治的103例老年创伤患者为研究对象,基于患者实验室检查、体成分数据等多维度描述老年创伤患者的营养状况。依据微型营养评定法(MNA-SF)的结果将患者进行营养风险分组,其中营养风险组46例,营养正常组57例,分析老年创伤患者营养状况及其影响因素。采用SPSS 19.0统计软件进行数据分析。根据数据类型,分别采用t检验、秩和检验或χ2检验进行组间比较。采用二分类变量的多元逐步logistic回归分析老年创伤患者营养状况的影响因素。结果 MNA-SF筛出营养状况良好者57例,潜在营养不良者39例,营养不良者7例,合计营养风险发生率为44.66%(46/103)。老年创伤患者还存在能量摄入不足、血糖较高、体脂偏高、骨骼肌质量减少、体蛋白质水平偏低等营养问题。logistic回归分析结果显示,高体脂(OR=0.126,95%CI 0.022~0.707;P=0.019)、低血清白蛋白(OR=3.579,95%CI 1.365~9.388;P=0.010)及低骨骼肌质量指数(OR=4.757,95%CI 1.854~12.209;P=0.001)与老年创伤患者的营养风险具有较高的相关性。存在营养风险(Z=-2.908,P=0.004)和低血清白蛋白(Z=-3.511,P<0.001)的老年创伤患者住院时间更长。结论 老年创伤患者存在诸多营养问题,营养风险发生率较高,且与患者住院时间相关,需及时监测营养状况,重点关注低体脂、低血清白蛋白、低骨骼肌质量指数的老年患者,及时给予营养支持,以改善其营养状况及预后。
英文摘要:
      Objective To analyze the nutritional status and its influencing factors of elderly trauma patients in perioperative period so as to provide scientific basis for early nutritional intervention and clinical diagnosis and treatment, promote clinical outcomes and prognosis, and improve their quality of life. Methods A total of 103 elderly trauma patients admitted in West China Hospital of Sichuan University from January 2021 to December 2021 were included in the study. The results of laboratory examinations and body composition data were recorded to describe the nutritional status of elderly trauma patients in multiple dimensions. According to the evaluation results of mini nutritional assessment-short form (MNA-SF), they were divided into nutritional risk group (n=46) and normal nutrition group (n=57). The nutritional status and the influencing factors were studied in the elderly trauma patients. SPSS statistics 19.0 was used to perform the statistical analysis. Student′s t test, rank sum test or Chi-square test was employed for intergroup comparison. Multivariate stepwise logistic regression for binary variables was performed to analyze influencing factors of nutritional status in elderly trauma patients. Results The results of MNA-SF showed there were 57 patients with good nutritional status, 39 with potential malnutrition, and 7 with malnutrition, with an incidence of nutritional risk of 44.66% (46/103). Elderly trauma patients also had nutritional problems such as insufficient energy intake, high blood glucose, high body fat, reduced skeletal muscle mass and low body protein level. Logistic regression analysis indicated that high body fat (OR=0.126,95%CI 0.022-0.707; P=0.019), low serum albumin level (OR=3.579,95%CI 1.365-9.388; P=0.010) and low skeletal muscle mass index (OR=4.757,95%CI 1.854-12.209; P=0.001) were significantly associated with nutritional risk in elderly trauma patients. The length of hospital stay was prolonged in the patients with nutritional risk (Z=-2.908, P=0.004) and those with low serum albumin level (Z=-3.511, P<0.001). Conclusion Elderly trauma patients had many nutritional problems and are at high nutritional risk, which is associated with the length of hospital stay. Monitoring of nutritional status should be carried out, especially in those with low body fat, serum albumin and skeletal muscle mass index. Timely nutritional support should be given to improve their nutritional status and prognosis.
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