744例住院老年肿瘤患者营养不良状况调查及分析

The analysis and the investigation of malnutrition in 744 elderly inpatients with tumor

目的调查本院住院老年恶性肿瘤患者营养不良的发生情况,进一步分析其与不同临床因素的相关性。方法采用横断面调查法,应用PG-SGA对我院住院老年恶性肿瘤患者进行营养不良筛查与评估,分析营养状况与年龄、肿瘤分期、治疗手段、住院时间及费用等临床因素的相关性。结果 (1)老年恶性肿瘤患者744例,营养不良发生率高达67.9%;(2)老年胃肠道恶性肿瘤患者发生轻/中度营养不良及重度营养不良比率均明显高于非胃肠道恶性肿瘤患者,分别为81.9%vs58.2%,40.5%vs 22.7%,P值均<0.001;(3)老年胃肠道恶性肿瘤患者营养状况与临床因素相关性分析:(1)年龄:营养不良发生率与年龄因素无明显相关性,P=0.462;(2)临床分期:Ⅰ+Ⅱ期患者营养不良发生率为79.3%(88/111),Ⅲ期为88.8%(103/116),Ⅳ期为87.5%(42/48),P=0.595,无统计学差异;(3)治疗手段:接受化疗患者(236例)营养不良发生比率明显高于仅接受手术患者(37例),86.0%vs 64.9%,P=0.001;(4)住院费用:无营养不良、轻/中度营养不良和重度营养不良患者中位住院费分别为12,420.15元、15,384.20元、20,672.70元,P=0.004,重度营养不良患者住院费用明显高于前两者;(5)住院时间:无营养不良、轻/中度营养不良和重度营养不良患者中位住院时间分别为6.50天、7.50天和14.00天,P=0.002,重度营养不良患者住院天数明显多于前两者。结论 (1)老年肿瘤患者营养不良现象普遍存在,尤以胃肠道肿瘤为著;(2)老年肿瘤患者合并营养不良会明显增加住院费用、延长住院时间;(3)不同治疗手段对营养状态存在不同程度的影响,应权衡利弊,合理应用;(4)关注老年肿瘤患者的营养状况,及早筛查、及时干预。

Objective It was investigated the incidence of malnutrition in elderly patients with malignant tumor in our hospital,and further analyzed the correlation among malnutrition and different clinical factors.Methods:PG-SGA was determined for the cancer inpatients in our hospital,then we analyzed the relativities among the age、stages、therapy、length of stay(LOS)、cost and other clinical factors.Results(1)The incidence of malnutrition was up to 67.9%in these 744 elderly inpatients;(2)Compared with non-gastrointestinal cancer patients,the incidence of malnutrition(81.9%vs 58.2%)and severe-malnutrition(40.5%vs 22.7%)increased significantly in patients with gastrointestinal cancer(P<0.001).(3)Correlation analysis of nutritional status and clinical factors in elderly patients with gastrointestinal malignant tumor:①According to the Stratification by using age factors,malnutrition rates were no significant difference in patients(P=0.462);②Different stages(TNM)didn’t show any difference on nutritional status(P=0.595),The malnutrition incidence of StageⅠ+Ⅱpatients was 79.3%(88/111),and StageⅢwas 88.8%(103/116),StageⅣwas 87.5%(42/48);③Compared with chemotherapy(236 cases),elderly cancer patients with surgery(37cases)had a lower rate of malnutrition(86.0%vs 64.9%,P=0.001);④The median costs of hospitalization for patients with severe malnutrition(20672.70 yuan)were significantly higher than those without malnutrition(12420.15 yuan)or mild/moderate malnutrition(15384.20 yuan),P=0.004,and there was no significant difference in between the latter;⑤The median length of stay for patients with severe malnutrition(14.00 days)were significantly higher than those without malnutrition(6.50 days)or mild/moderate malnutrition(7.50 days),P=0.002,and there was no significant difference in between the latter.Conclusion:①Malnutrition is common in elderly patients with malignant tumors,especially in gastrointestinal cancers;②The elderly cancer patients with severe malnutrition will significantly increase the cost of hospitalization and the length of stay;③Different treatments have different effects on nutritional status,so we should judge and weigh the advantages and disadvantages and choose the right treatment;④We should pay more attention to the nutritional status of elderly cancer patients,and it’s important early screening and timely intervention.