营养状况与老年人急性卒中相关感染的关系研究

Correlation between nutritional status screened by MNA-SF and acute stroke-associated infections in the elderly

目的探讨老年急性卒中病人入院时营养状态与卒中相关感染(stroke-associated infections,SAI)的相关性。方法回顾性连续纳入2018年1月至2020年6月发病24 h内入院的年龄≥70岁的急性脑卒中病人;应用微型营养评估简表(mini nutritional assessment short-form,MNA-SF)评估所有病人的基线营养状况,根据评分结果分为营养状况正常组、营养不良风险组、营养不良组;同时记录并比较3组病人的基线临床资料,包括卒中类型、人口统计学资料、实验室检查指标及住院期间SAI的发生情况等。应用多因素Logistic回归分析SAI发生的危险因素,确定营养状态与SAI的相关性。结果本研究包括233例病人,年龄70~90岁,平均(77.02±6.60)岁,其中142例(60.9%)病人是男性。有51例(21.9%)病人并发了SAI;营养不良、营养不良风险和营养正常病人SAI发生率分别为34.0%、26.2%和12.7%,3组比较差异有统计学意义(P=0.007)。多因素Logistic回归分析结果表明,有营养不良风险(OR3.401,95%CI1.414~8.181)及营养不良(OR4.088,95%CI1.612~10.363)的老年卒中病人更容易发生SAI。结论存在营养不良及营养不良风险的老年急性卒中病人是SAI的高危人群,临床上应尽早实施营养支持。

Objective To investigate the correlation between nutritional status and stroke-associated infections(SAI)in the elderly patients with acute stroke.Methods The patients with acute stroke aged over 70 years who were admitted to the hospital within 24 h of disease attack from January 2018 to June 2020 were retrospectively enrolled in this study.The baseline nutritional status of all patients was assessed by using the mini nutritional assessment short-form(MNA-SF).Then,all patients were divided into normal nutritional status group,malnutrition risk group and malnutrition group.At the same time,the baseline clinical data of the patients in the three groups,including stroke type,demography,laboratory examination and the incidence of SAI were collected and analyzed.Moreover,the risk factors of SAI were identified by multivariate Logistic regression,so as to determine the correlation between nutritional status and SAI.Results This study included 233 patients with a mean age of 77.02±6.60 years,ranging 70-90 years,and 142(60.9%)patients were male.There were 51(21.9%)patients with concomitant SAI.According to MNA-SF assessment,34.0%of the patients with malnutrition presented with SAI,while 26.2%of the patients with malnutrition risk presented with SAI.Compared with the patients with normal nutrition(12.7%),the incidence rate of SAI in the three groups was statistically different(P=0.007).Multivariate analysis showed that malnutrition risk(OR=3.401,95%CI=1.414-8.181)and malnutrition(OR=4.088,95%CI=1.612-10.363)were the risk factors of SAI.Conclusions The elderly patients with acute stroke who have malnutrition and malnutrition risk are identified as the high-risk group of SAI.Nutritional support should be implemented as early as possible for such patients.