营养风险对老年慢性阻塞性肺疾病患者非计划性再入院的影响

Impact of nutritional risk on unplanned readmissions in elderly patients with chronic obstructive pulmonary disease

目的探讨营养风险对老年慢性阻塞性肺疾病(简称慢阻肺)患者非计划性再入院的影响,为临床营养支持干预提供依据。方法采用营养风险筛查表(NRS 2002)和非计划性再入院情况调查表对2014年6月至2015年5月符合纳入标准的老年慢阻肺住院患者进行问卷调查,并测量身高、体重,计算体重指数。结果老年慢阻肺患者营养风险筛查总分为(4.65±1.33)分,无营养风险者456例(40.07%),有营养风险者682例(59.93%)。15 d内非计划性再入院47例(4.13%),30 d内155例(13.62%),60 d内265例(23.28%),180 d内336例(29.53%),1年内705例(61.95%)。有营养风险的患者60 d、180 d及1年内非计划性再入院率显著高于无营养风险者(P均<0.05)。老年慢阻肺患者的年龄、疾病严重程度及营养风险影响180 d内非计划性再入院(P均<0.05)。结论营养风险与老年慢阻肺患者非计划性再入院密切相关。医护工作者应根据老年慢阻肺患者发生营养风险的原因采取相应的措施来降低患者的营养风险,降低患者的非计划性再入院。

Objective To investigate the impact of nutritional risk on unplanned readmissions in elderly patients with chronic obstructive pulmonary disease （COPD）, to provide evidence for clinical nutrition support intervention. Methods Elderly patients with COPD meeting the inclusive criteria and admitted between June 2014 and May 2015 were recruited and investigated with nutritional risk screening 2002 （NRS 2002） and unplanned readmission scale. Meanwhile, the patients＇ body height and body weight were measured for calculating body mass index （BMI）. Results The average score of nutritional risk screening of the elderly COPD patients was 4.65±1.33. There were 456 （40.07%） patients who had no nutritional risk and 682 （59.93%） patients who had nutritional risk. There were 47 （4.13%） patients with unplanned readmissions within 15 days, 155 （13.62%） patients within 30 days, 265 （23.28%） patients within 60 days, 336 （29.53%） patients within 180 days, and 705 （61.95%） patients within one year. The patients with nutritional risk had significantly higher possibilities of unplanned readmissions within 60 days, 180 days and one year than the patients with no nutritional risk （all P〈0.05）. The nutritional risk, age and severity of disease influenced unplanned readmissions of the elderly patients with COPD （all P〈0.05）. Conclusions There is a close correlation between nutritional risk and unplanned readmissions in elderly patients with COPD. Doctors and nurses should take some measures to reduce the nutritional risk so as to decrease the unplanned readmissions to some degree.