老年骨科良性疾病住院患者的营养不足和营养风险

Undernutriton and nutritional risk in elderly inpatients with benign orthopedic diseases in Department ;of Orthopedics

目的：调查老年骨科良性疾病住院患者的营养状态，分析其与临床结局的相关性。方法应用营养风险筛查2002（ NRS2002）方法，前瞻性调查2012年4月1日至5月31日因患良性骨科疾病入院老年患者的营养不足和营养风险发生率，并分析其与临床结局的相关性。结果共纳入520例老年骨科患者，平均年龄为（75±7．09）岁，平均体质量指数（ BMI）为（23．20±3．83） kg／m2，平均利手握力为（16．87±19．19） kg，平均上臂围为（25．62±3．81） cm，平均小腿围为（31．92±4．02） cm，其中与普通老年患者比较，高龄（≥80岁）老年患者握力下降明显[（13．58±15．92） kg比（18．48±20．42） kg， P ＝0．004]。520例患者进行营养风险筛查，营养不足发生率为9．31％（BMI≤18．5 kg／m2），营养风险发生率为45．19％（NRS2002评分≥3分）；与普通（65～79岁）老年骨科患者比较，高龄（≥80岁）老年骨科患者营养不足和营养风险发生率均显著增加（13．97％比7．21％， P＝0．024；52．38％比41．76％， P ＝0．024），有营养风险者的感染并发症发生率更高（10．21％比5．26％， P ＝0．044）、住院时间更长[（11．66±5．76） d 比（10．42±4．37） d， P ＝0．016]和住院费用更高[（2．028±1．811）万元比（1．639±1．362）万元， P＝0．016]。结论老年骨科良性疾病住院患者营养不足和营养风险发生率较高，并且可能导致临床结局恶化。

Objective To investigate the nutritional status of elderly inpatients with benign orthopedic diseases and to assess its relationship with clinical outcomes.Methods Nutritional Risk Screening 2002 （ NRS 2002） was used to prospectively investigate undernutrition and nutritional risk in elderly patients hospitalized between April 1 and May 31, 2012 in Beijing Hospital for benign orthopedic diseases.Associations between nu-tritional status and clinical outcomes were analyzed.Results A total of 520 patients were included, with a mean age of （75 ±7.09） years.The mean body mass index （BMI） was （23.20 ±3.83） kg/m2, mean dominant-hand grip strength was （16.87 ±19.19） kg, mean mid-upper arm circumference was （25.62 ±3.81） cm, mean calf circumference was （31.92 ±4.02） cm.Compared with patients aged 65-79 years, patients≥80 years showed significantly lower hand grip strength [ （13.58 ±15.92） kg vs.（18.48 ±20.42） kg, P=0.004].All the pa-tients completed NRS 2002, which showed that 9.31%of the patients had undernutrition （BMI≤18.5 kg/m2）, and 45.19%had nutritional risk （NRS 2002 score≥3）.Compared with patients aged 65-79 years, patients≥80 years had significantly higher incidence of undernutrition （13.97% vs.7.21%, P=0.024） and nutritional risk （52.38%vs.41.76%, P=0.024）, higher incidence of infectious complications in patients with nutritional＆amp;nbsp;risk （10.21%vs.5.26%, P=0.044）, longer hospital stay [ （11.66 ±5.76） days vs.（10.42 ±4.37） days, P=0.016], and higher hospital expense [（20.28 ±1.811） thousand yuan vs.（16.39 ±1.362） thousand yuan, P=0.016].Conclusion Elderly patients hospitalized for benign orthopedic diseases have a high incidence of undernutrition and nutritional risk, which is associated with worse clinical outcomes.