老年外科患者跌倒风险与营养状态的相关性

Correlation between the risk of falling and nutritional status in elderly surgical patients

目的凋查老年外科患者的跌倒风险和营养状态，分析其相关性。方法对2015年1至6月在北京医院普外科住院的年龄≥65岁的老年患者，应用Morse跌倒评估量表评价其跌倒风险，应用人体物理测量指标、人体组分测定和营养风险筛查2002（NRS2002）等方法，评价老年患者的营养状态，并进行相关性分析。结果共纳入383例患者，普通老年（65—79岁）患者314例，高龄（≥80岁）患者69例。与普通老年患者比较，高龄患者的握力[（24．53±8．09）kg比（30．57±8．48）kg]和4m步速[（0．66±0．19）m／s比（0．84±0．20）m／s]显著降低（均P〈0．05）。高龄患者营养不足和营养风险发生率显著高于普通老年患者[15．9％（11／69）比7．O％（22／314），56．5％（39／69）比38．2％（120／314），均P〈0．05]。总体跌倒高度风险患者占33．9％（130／383），高龄患者中跌倒高度风险者占44．9％（31／69），显著高于普通老年患者的31．5％（99／314）（P=0．036）；有跌倒高度风险的老年患者，其体质量指数[（22．33±1．82）kg／m。比（23．76±3．26）kg／m。]和握力[（24．95±8．56）kg比（30．72±8．39）蚝]更低，营养风险发生率较高[46．9％（61／130）比38．7％（98／253）]（均P〈0．05）。结论老年普外科住院患者存在较高的跌倒高度风险发生率，且与患者的营养状态相关联，应重视老年外科患者的护理和营养干预，预防跌倒发生，提高医疗质量。

Objective To investigate the risk of failing and nutritional status in elderly surgical patients, and to assess the correlation between them. Methods Patients aged ≥65 in Department of General Surgery of Beijing Hospital between January and June 2015 were enrolled in this study. The Morse Fall Scale was used to evaluate the risk of falling. Anthropometrics, body composition, and Nutritional Risk Screening 2002 （ NRS 2002） scores were collected to evaluate the nutritional status of the patients. The correlation between risk of falling and nutritional status was analyzed. Results A total of 383 patients were included, including 314 cases under 80 （65 -79 years） and 69 cases 〉/80. Patients /〉80 years showed significantly lower grip [ （24.53 ± 8.09）kgvs. （30.57 ±8.48）kg, P〈0.051 and4-meter gait speed [（0.66 ±0. 19）m/s vs. （0.84± 0.20） m/s, P 〈 0.05 ], but significantly increased undernutrition [ 15.9 % （ 11/69） vs. 7.0% （22/314）, P 〈 0.05 ] and nutritional risk [ 56.5 % （39/69） vs. 38.2% （ 120/314）, P 〈 0.05 ]. Altogether 33.9 % of the patients （130/383） were at high risk of falling, and the prevalence was significantly higher in patients I〉 80 than in patients 〈80 [44.9% （31/69） vs. 31.5% （99/314）, P =0. 036]. Compared with patients not at high risk of falling, high-risk patients had lower body mass index [ （22.33 ± 1.82）kg/m2 vs. （23.76 ±3.26）kg/m2] and grip [ （24.95 ±8.56）kg vs. （30.72 ±8.39） kg], but higher prevalence of nutritional risk [46.9% （61/130） vs. 38.7% （98/253） ] （all P 〈 0.05）. Conclusions Elderly surgical patients have a high risk of fall- ing, which may be related with their nutritional status. Nursing and nutrition intervention should be emphasized in there patients to prevent failing and improve clinical outcome.