北京地区老年住院患者营养风险、营养不良发生率及营养支持应用状况

Prevalence of nutritional risks and malnutrition and application of nutritional support in elderly inpatients in Beijing

目的了解老年住院患者营养风险、营养不良发生率以及营养支持应用状况，为存在营养不良及营养风险的老年患者及时接受营养支持提供参考依据。方法选取2010年7月至2011年6月北京大学人民医院老年科住院的老年 患者，于人院后第2天采用营养风险筛查2002（NRS2002）进行营养风险筛查，并于营养风险筛查2周内或至出院时进行营养支持应用状况调查，分析营养风险和营养支持之间的关系。结果共有445例住院患者入选，其中423例（95．1％）完成NRS2002筛查。营养不足和营养风险的发生率分别为4．7％和13．2％，其中230例超重和肥胖患者的营养风险发生率为6．1％。56例有营养风险的患者，15例（26．8％）接受了营养支持；367例无营养风险的患者，14例（3．8％）接受了营养支持。所有接受营养支持患者肠外和肠内营养的应用比例为1．6：1。结论老年科有一定数量的患者存在营养风险或营养不足，营养支持应用仍存在某些不合理性，应推广和应用基于证据的营养支持指南来改善此状况；NRS2002不适用于超重或肥胖的老年住院患者。

Objective To investigate the prevalence of nutritional risks and malnutrition as well as the ap plication of nutritional support in the department of geriatrics. Methods Elderly inpatients in the Geriatric Depart ment of Peking University People＇s Hospital were consecutively enrolled from July 2010 to June 2011. Nutritional Risk Screening 2002 （ NRS 2002） was performed on the second day after admission, and nutritional support was investigated on the 14th day or the discharge day. The relationship between nutritional risk and nutritional support was analyzed. Results A total of 445 patients were enrolled, and 423 patients （95.1% ） underwent NRS 2002. The overall prevalence of undernutrition was 4.7% and nutritional risk was 13.2%. In 230 patients with over weight/obesity, the prevalence of nutritional risk was 6.1%. Nutritional support was provided to 15 patients （26.8%） with NRS 2002 〉13 and 14 patients （3.8%） with NRS 2002 〈 3. The average parenteral nutrition：en teral nutrition ratio was I. 6：1. Conclusions A large proportion of elderly inpatients are at nutritional risk or suffer from undernutrition in the geriatric department in Beijing. The application of nutritional support currently is some how inappropriate. Evidencebased guidelines are required to improve this situation. NRS 2002 is not applicable for elderly inpatients with overweight/obesity.