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Nutritional risk, malnutrition and nutritional support among hospitalized patients in orthopedics/spinal surgery of a Hohhot teaching hospital

呼和浩特教学医院脊柱骨科住院患者营养风险、营养不良及营养支持情况调查

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摘要


调查呼和浩特教学医院脊柱骨科患者入、出院(或入院2 周后)时营养状况(营养风险、营养不良、超重及肥胖的发生率)的变化及其住院期间营养支持的应用情况。采用定点连续抽样的方法,对该院两个脊柱骨科病房(传统脊柱骨科及微创脊柱骨科)2013年1月至12月的432例符合入组条件的住院患者进行调查分析。于入院48小时内采用营养风险筛查工具2002(NRS 2002)进行营养风险筛查,记录患者住院期间的营养支持情况。该院脊柱骨科营养风险、营养不良、超重及肥胖的总体发生率分别为 11.6%, 12.7%, 35.9%及7.41%。88%有营养风险的患者住院期间接受了营养支持治疗;但该院仍有14.1%的无营养风险患者接受了额外的营养支持。调研的脊柱骨科患者中,营养风险发生率由入院时的11.6%变化为出院时的19.4%(p<0.05);营养不良发生率由12.7%变化为20.6%(p<0.05);超重及肥胖分别由入院时的35.9%和7.41%变化为出院时的31.0%和5.79%,变化无统计学意义。NRS 2002 是脊柱骨科患者有用的营养风险筛查工具。该院脊柱骨科患者住院期间的营养风险及营养不良的发生率均显著增高,同时该院营养支持药物的使用存在较多不合理现象,营养支持的指南或方案应由专业委员会提出。

並列摘要


The evolution of nutritional status (the prevalence of nutritional risk, malnutrition, overweight and obesity) and the nutritional support of the hospitalized patients from admission to discharge or over a two-week period in orthopedics/ spinal surgery of a teaching hospital in Hohhot were investigated. 432 patients from two wards of the orthopedics/spinal surgery from Jan to Dec 2013, the traditional spinal surgery and the minimally invasive spinal surgery, were selected and detected in this study. The Nutritional Risk Score 2002 (NRS 2002) was used to determine the patients' nutritional status within 48h after admission and during their hospitalization. The overall prevalence of nutritional risk, malnutrition, overweight and obesity at admission was 11.6%, 12.7%, 35.9% and 7.41%, respectively. Overall, there were 88.0% of the patients who were at nutritional risk received nutritional support, while 14.1% of non-risk patients received a redundant nutritional support. The overall prevalence of nutritional risk changed from 11.6% at admission to 19.4% upon discharge (p<0.05), and the prevalence of malnutrition changed from 12.7% to 20.6% (p<0.05). The prevalence of overweight and obesity, which changed from 35.9% to 31.0% and from 7.41% to 5.79% respectively, didn't experience statistically significant evolution. NRS 2002 was a feasible nutritional risk screening tool for patients in spinal surgery of orthopedics department. Patients' prevalence of nutritional risk and malnutrition increased significantly in spinal surgery of this hospital. Some inappropriate uses of nutritional support were observed in orthopedics/spinal surgery, and nutritional support guidelines or protocols should be promoted by a professional committee.

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