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Desnutrición proteico-energética entre pacientes hospitalizados de edad avanzada: un estudio prospectivo
D H Sullivan1, S Sun, R C Walls
1Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock 72205, USA. sullivandennish@Exchange.UAMS.edu
JAMA
|June 8, 1999
Resumen
Muchos pacientes de edad avanzada en los hospitales reciben una ingesta inadecuada de nutrientes, lo que aumenta su riesgo de mortalidad. La intervención temprana para prevenir los déficits nutricionales durante la hospitalización es crucial para mejorar los resultados de los pacientes.
Área de la Ciencia:
- Gerontología Gerontología.
- Nutrición clínica La nutrición clínica es la nutrición clínica.
- El Hospital El Hospital La Medicina La Medicina.
Sus antecedentes:
- Los pacientes ancianos hospitalizados a menudo experimentan déficits nutricionales, relacionados con un aumento de la morbilidad.
- La contribución de la ingesta de nutrientes en el hospital a estos déficits y resultados adversos sigue sin estar clara.
Objetivo del estudio:
- Determinar la ingesta diaria promedio de nutrientes en pacientes ancianos hospitalizados con enfermedades no terminales.
- Identificar los factores asociados con una ingesta persistentemente baja de nutrientes.
- Evaluar la correlación entre la ingesta adecuada de nutrientes y el riesgo de mortalidad.
Principales métodos:
- Estudio de cohorte prospectivo (1994-1997) en un hospital de veteranos afiliado a una universidad.
- Involucrado 497 pacientes ancianos (≥65 años) con ≥4 días de duración de la estancia.
- Mide la ingesta diaria de nutrientes en el hospital, la mortalidad en el hospital y la mortalidad a los 90 días.
Principales resultados:
- El 21% de los pacientes tenían una ingesta de nutrientes <50% de las necesidades estimadas.
- La baja ingesta de nutrientes se asoció con niveles más bajos de colesterol sérico, albúmina y prealbumina.
- Los pacientes con baja ingesta de nutrientes se enfrentaron a una mortalidad hospitalaria significativamente mayor (RR 8.0) y a una mortalidad a los 90 días (RR 2.9).
- La ingesta inadecuada se debió a los pedidos de "nada por la boca" y la subutilización de los suplementos / rutas de alimentación.
Conclusiones:
- Muchos pacientes de edad avanzada reciben nutrientes insuficientes durante la hospitalización, lo que potencialmente aumenta la mortalidad.
- La prevención de los déficits nutricionales durante la hospitalización es esencial, dados los desafíos para revertirlos más adelante.
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