郑州某三甲医院营养风险及营养不良(按GLIM)患病率(7 247例横断面调查)

Prevalence of nutritional risks and malnutrition by GLIM among the inpatients of a tertiary A hospital in Zhengzhou

目的调查郑州市某三甲医院住院患者营养风险及营养不良患病率。方法采用整群抽样,横断面调查研究,对2016年11月至2017年12月河南省人民医院肿瘤内科、肿瘤介入科、胃肠外科、肝胆胰外科、神经内科、脑血管介入科住院患者,用营养风险筛查(NRS 2002)按计划分析营养风险患病率,用全球(营养)领导层倡议营养不良(GLIM)诊断标准(共识)第2步、3步,回顾性分析营养不良及重度营养不良患病率。结果按照整群抽样6个科室共计7247例患者记录在案,经纳入标准和排除标准核查并分病组,5802例患者入组,共10个病种(病组),其中脑卒中患者营养风险患病率为28.1%(421/1498),应用GLIM诊断营养不良患病率为3.0%(45/1498)、重度营养不良患病率为1.0%(15/1498),癌症患者4304例(食管癌、胃癌、结直肠癌、肝胆癌、胰腺癌、肺癌、乳腺癌、卵巢子宫癌和淋巴瘤):营养风险为39.3%(1693/4304),应用GLIM诊断营养不良患病率为19.8%(852/4304)、重度营养不良患病率12.2%(523/4304)。≥60岁者的营养风险、营养不良及重度营养不良患病率高于<60岁者(P<0.05)。癌症晚期(不包括终末期)患者的营养风险、营养不良患病率及重度营养不良患病率高于早中期(P<0.05)。结论≥60岁者及晚期癌症患者的营养风险、营养不良及重度营养不良患病率较高,需得到更多关注。GLIM诊断营养不良标准在临床可行,但与临床结局改善的关系有待前瞻性临床有效性验证。

Objective To investigate the nutritional risk and malnutrition among inpatients in a tertiary A hospital in Zhengzhou.Methods The cluster sampling and cross-sectional survey research were used in hospitalized patients from November 2016 to December 2017 in Henan province people's hospital,Nutritional Risk Screening 2002(NRS 2002)was used to analysis the prevalence of nutritional risk as planned and The Global Leadership Initiative on Malnutrition(GLIM)step 2 and step 3 were used to retrospective analysis the prevalence of malnutrition and severe malnutrition.Results A total of 7247 patients in 6 departments were recorded according to the cluster sampling,and 5802 patients were enrolled according to the inclusion and exclusion criteria and divided into disease groups.The 10 diseases(groups)were:stroke patients,of which the prevalence of nutritional risk was 28.1%(421/1498),GLIM malnutrition was 3.0%(45/1498)and severe malnutrition was 1.0%(15/1498),and cancer patients were 4304(esophageal,gastric,colorectal,hepatobiliary,pancreatic,lung,breast,ovarian and uterine cancer and malignant lymphoma),of which the prevalence of nutritional risk was 39.3%(1693/4304),GLIM malnutrition was 19.8%(852/4304),and severe malnutrition prevalence was 12.2%(523/4304).The prevalence of nutritional risk,malnutrition and severe malnutrition in the elderly was higher than that in the non-elderly(P<0.05).The prevalence of nutritional risk,malnutrition and severe malnutrition in patients with advanced cancer(not including the terminal stage)was higher than those in the early and middle stages(P<0.05).Conclusion The prevalence of nutritional risk and malnutrition was higher in elderly patients and patients with advanced cancer,the nutrition situation of those groups require more attention.GLIM is clinically feasible for the diagnosis of malnutrition,but its association with improved clinical outcomes remains to be prospectively validated.