老年社区获得性肺炎患者营养风险调查及影响因素分析

Nutritional risk investigation and influencing factors analysis of elderly patients with community-acquired pneumonia

目的探究老年社区获得性肺炎(community-acquired pneumonia,CAP)患者营养风险调查及影响因素分析。方法回顾性分析2022年1月至2024年1月期间于西部战区总医院收治的239例老年CAP患者的临床资料,采用营养风险筛查量表(NRS2002)对患者行营养风险调查;按营养风险调查结果将239例老年CAP患者分为风险较高组(NRS2002≥3分)和风险较低组(NRS2002<3分),经单因素分析比较其性别、年龄、文化水平、居住情况、肺炎严重程度、吸烟史、有无慢性疾病、认知功能障碍、自理能力等因素差异,经二元logistic回归分析影响老年CAP患者营养风险的独立危险因素。结果根据NRS2002量表评分结果,风险较高组有87(36.4%)例和风险较低组有152(63.6%)例。且风险较高组的NRS2002评分显著高于风险较低组(P<0.05)。两组患者的性别差异无统计学意义(P>0.05);风险较高组的年龄>70岁的比率、文化水平(高中及以下)的比率、居住情况(独居)的比率、肺炎严重程度(高危肺炎)的比率、慢性疾病的比率、认知功能障碍的比率、自理能力较差的比率显著高于风险较低组(P<0.05)。二元logistic回归分析结果显示,年龄>70岁、文化水平在高中及以下、居住情况(独居)、肺炎严重程度(高危肺炎)、有慢性疾病、认知功能障碍和自理能力(较差)均为影响老年CAP患者存在营养风险的独立危险因素(P<0.05)。结论老年CAP患者存在较高的营养风险,且可能受到患者年龄、文化水平、居住情况、肺炎严重程度、有无慢性疾病、认知功能障碍、自理能力等多种因素影响,可以其为依据制定有针对性的干预措施,以改善患者存在营养风险的问题。

Objective To explore the nutritional risk investigation and influencing factors of elderly patients with community-acquired pneumonia(CAP).Methods The clinical data of 239 elderly patients with CAP in Western Theater General Hospital were retrospectively analyzed from January 2022 to January 2024.Nutritional risk screening scale(NRS2002)was used to investigate the nutritional risk of patients.According to the nutritional risk investigation results,239 elderly patients with CAP were divided into higher risk group(NRS2002≥3 points)and lower risk group(NRS2002<3 points).Univariate analysis was used to compare the gender,age,education level,body mass index(BMI),family monthly income,living condition,severity of pneumonia,smoking history,presence or absence of chronic diseases,cognitive dysfunction and self-care ability.The independent risk factors of nutritional risk in elderly patients with CAP were analyzed by binary logistic regression analysis.Results According to NRS2002 score,there were 87 cases(36.4%)in higher risk group and 152 cases(63.6%)in lower risk group.The NRS2002 scores in higher risk group were significantly higher than those in lower risk group(P<0.05).There were no obvious differences in gender,BMI,family monthly income and presence or absence of smoking history between groups(P>0.05).The higher risk group had significantly higher rates of age>70 years old,education level(high school and below),living condition(living alone),severity of pneumonia(high-risk pneumonia),chronic disease,cognitive dysfunction and poor self-care ability than the lower risk group(P<0.05).Binary logistics regression analysis showed that age>70 years old,education level of high school and below,living condition(living alone),severity of pneumonia(high-risk pneumonia),chronic diseases,cognitive dysfunction and self-care ability(poor)were independent risk factors for nutritional risk in elderly CAP patients(P<0.05).Conclusion Elderly patients with CAP have high nutritional risk,which may be affected by many factors such as age,education level,living condition,severity of pneumonia,presence or absence of chronic diseases,cognitive dysfunction and self-care ability.It is necessary to formulate targeted intervention measures according to the above factors to improve the nutritional risk of patients.