老年糖尿病足溃疡住院患者营养状况及营养不良相关影响因素研究

Nutritional status and related factors of malnutrition in elderly inpatients with diabetic foot ulcer

目的对老年糖尿病足溃疡(DFU)住院患者的营养状况进行调查,并分析其营养不良的相关影响因素。方法以2019年1月1日至2020年12月31日在西安市某医院内分泌科收治的初诊≥60岁DFU住院患者为研究对象进行营养状况相关调查,采用描述流行病学分析方法对老年DFU患者营养不良发生情况进行分析,并对DFU患者发生营养不良影响因素进行单、多因素分析。结果纳入研究的559例住院老年DFU患者中男321例,女238例,男女比为1.3∶1。年龄为60~88岁,平均年龄(71.57±4.39)岁。559例老年DFU患者的微型营养评估表评分为(14.81±4.39)分,营养不良者387例,营养不良率为69.23%。多因素Logistic回归分析结果显示,年龄每增加10岁(OR=2.344)、糖尿病病程>5年(OR=2.179)、DFU感染(OR=1.728)、糖化血红蛋白>7.0%(OR=2.502)、C反应蛋白≥10 mg/L(OR=1.850)、Wagner分级为3~5级(OR=8.406)、老年抑郁量表评分越高(OR=6.013)的老年DFU患者营养不良的发生风险越大,日常生活活动能力评分越高(OR=0.106)的老年DFU患者营养不良的发生风险越小。结论老年DFU住院患者营养不良率较高,影响营养状况的相关因素众多,应及时提出针对性预防和干预措施对营养状况进行改善。

Objective To investigate the nutritional status of elderly inpatients with diabetic foot ulcer(DFU)and analyze the related factors of malnutrition.Methods Inpatients aged ≥60 years old with newly diagnosed DFU who were admitted to the endocrinology department of a hospital in Xi′an from January 1,2019 to December 31,2020 were taken as the research subjects to carry out a nutritional status-related survey. The incidence of malnutrition in elderly DFU patients was analyzed by descriptive epidemiological analysis,and the influencing factors of malnutrition in DFU patients were analyzed by univariate and multivariate analysis methods.Results Among the 559 elderly inpatients with DFU included in the study,there were 321 males and 238 females,with a male-to-female ratio of 1.3∶1. The age ranged from 60 to 88 years old,with an average age of(71.57±4.39)years. The mini-nutritional assessment score of 559 elderly inpatients with DFU was(14.81±4.39),and 387 were malnutrition,with a malnutrition rate of 69.23%. The results of multivariate Logistic regression analysis showed that for every 10 years of age increase(OR=2.344),the course of diabetes mellitus>5 years(OR=2.179),DFU infection(OR=1.728),HbA1 c>7.0%(OR=2.502),C-reactive protein ≥10 mg/L(OR=1.850),Wagner grade 3-5(OR=8.406),the higher the geriatric depression scale score(OR=6.013),the higher the risk of malnutrition in elderly DFU patients;the higher the activity of daily living score(OR=0.106),the lower the risk of malnutrition in elderly DFU patients.Conclusion Malnutrition is common in elderly inpatients with DFU,and there are many related factors affecting their nutritional status. Targeted prevention and intervention measures for improving their nutritional status need to be strengthened.