老年危重病患者营养状态评估

Evaluation of nutritional status in critically ill elderly

目的分析ICU老年患者营养状态与预后的关系。方法 104例ICU老年患者分为病死组(51例)和存活组(53例),采用营养风险筛查2002(NRS 2002)评分联合血浆前白蛋白、白蛋白、转铁蛋白、淋巴细胞计数、C反应蛋白(CRP)检测和急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分。使用多元回归分析观察上述指标与预后之间的关系。结果病死组和存活组的血浆白蛋白、淋巴细胞计数、转铁蛋白、CRP、APACHEⅡ评分存在统计学差异(P<0.05);多元回归分析显示,NRS2002评分及APACHEⅡ评分是老年危重病患者预测死亡的独立危险因素。结论 NRS 2002评分和APACHEⅡ评分是判断老年危重病患者预后的有效指标。

Objective To investigate the correlation between nutritional status and prognosis in the elderly in geriatric ICU. Methods A total of 104 elder patients in geriatric ICU was divided into death group（ 51 cases） and survival group（ 53 cases）. The nutritional status was assessed by nutrition risk screening 2002 （NRS 2002） score combined with examination of plasma prealbumin, albumin, transferrin,lymphocyte counts and C-reactive protein（CRP）. The evaluation of acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score was performed as well. The relationship between above parameters and prognosis was analyzed with multivariate logistic regression analysis. Results There were significant differences in plasma albumin, lymphocyte counts, transferrin, CRP and APACHE Ⅱ score between two groups （P〈0. 05）. Multivariate logistic regression analysis showed that NRS 2002 score and APACHE Ⅱ score were the independent risk factors for predicting death of the elderly in geriatric ICU. Conclusion NRS 2002 score and APACHE Ⅱ score are useful parameters in predicting the prognosis of critically ill elderly.