老年人营养风险指数与重病老年人口术后不良结果之间的关联:一项回顾性研究
Sheng-Chang Ye1, Yu-Ting Mao2, Bo-Li Huang3
1Nursing department, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai JiaoTong University School of Nursing, Shanghai, China.
BMC pulmonary medicine
|April 4, 2025
概括
根据老年营养风险指数 (GNRI) 确定的主要营养风险显著增加了严重病情严重的老年人口术后不良结果. 这包括较高的死亡风险,肺炎,再输管和消化不良,突出了营养评估的重要性.
科学领域:
- 老年医学 老年医学
- 关键护理医学 关键护理医学
- 营养科学 营养科学
背景情况:
- 营养不良是老年重症监护室 (ICU) 患者不良结果的已知预测因素.
- 老年营养风险指数 (GNRI) 是评估老年人营养状况的有效工具.
研究的目的:
- 调查老年营养风险指数 (GNRI) 与严重病重的老年人口术后不良结果之间的关联.
- 确定GNRI定义的营养风险是否与机械通风停止后的特定不良事件相关.
主要方法:
- 一项回顾性队列研究包括1,153名入住ICU的老年人 (65-82岁).
- 患者被分为四个GNRI风险组:主要 (<82),中度 (82-91),低 (92-98) 和没有风险 (>98).
- 评估的不良结果包括30天死亡率,肺炎,72小时再输入,输出后食症和使用多变量回归和限制立方线 (RCS) 的停留时间 (LOS).
主要成果:
- 较低的GNRI得分显着与输出管后不良结果和更长的ICU/医院LOS (P<0.001) 有关.
- 主要营养风险组的患者的30天死亡率 (OR=2.76),肺炎 (OR=3.07),72小时再输管 (OR=2.41) 和输管术后失足症 (OR=2.94) 的几率明显更高.
- RCS分析证实了GNRI与死亡率/肺炎/缺血症之间的线性关系,而Kaplan-Meier分析显示主要风险组的30天生存率降低 (P=0.018).
结论:
- 低GNRI表示的主要营养风险是严重病重的老年人口术后不良结果的重要预测因素.
- 使用GNRI进行营养状况评估对于识别高风险患者和潜在地减轻ICU中的不良事件至关重要.
- 这些发现强调了营养干预措施对于改善这种脆弱患者群体的结果的重要性.
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