高齢の入院患者におけるタンパク質・エネルギー栄養不良:展望的研究

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

まとめ

病院にいる多くの高齢患者は,栄養素の摂取が不十分で,死亡リスクが高くなります. 入院中に栄養不足を防ぐための早期の介入は,より良い患者のアウトカムに不可欠です.

科学分野:

ゲロントロジーはゲロントロジーの学科です.
クリニカル・ニュートリション
病院病院医療病院医療

背景:

病院に入院している高齢患者は,しばしば栄養不足を経験し,罹病率の増加に関連しています.
病院内の栄養素摂取がこれらの欠乏と有害な結果に与える影響は不明である.

研究の目的:

非終末期疾患で入院している高齢患者の平均日々の栄養素摂取量を測定する.
持続的に低い栄養素摂取量に関連する要因を特定する.
栄養素摂取の充実と死亡リスクとの相関を評価する.

主な方法:

大学附属のVA病院で行われた前向きなコホート研究 (1994年~1997年).
参加者は497人の高齢患者 (≥65歳) で,滞在期間は≥4日でした.
病院内での毎日の栄養摂取量,病院内での死亡率,90日間の死亡率を測定したものです.

主要な成果:

患者の21%は,推定需要の50%未満の栄養素摂取量でした.
栄養素の摂取量が少ないと血清コレステロール,アルブミン,プレアルブミン値が低下することが関連していました.
栄養素の摂取量が少ない患者は,病院入院 (RR 8.0) と90日間の死亡率 (RR 2.9) が著しく高かった.
不十分な摂取は"口から何も摂取しない"という注文とサプリメント/栄養経路の不足によるものです.

結論:

多くの高齢患者は,入院中に栄養不足を受け,潜在的に死亡率を増やす可能性があります.
病院での入院中に栄養不足を予防することは,後でそれらを逆転させるという課題を考えると,不可欠です.

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