[1]周文婷,侯韦莲,李 毅.微型营养评价对高龄住院病人生存结局的预测价值研究[J].肠外与肠内营养杂志,2024,(06):321-328.[doi:10.16151/j.1007-810x.2024.06.001]
　ZHOU Wen-ting,HOU Wei-lian,LI Yi.The predictive value of mini-nutritional assessment on survival outcome of elderly inpatients[J].PARENTERAL & ENTERAL NUTRITION,2024,(06):321-328.[doi:10.16151/j.1007-810x.2024.06.001]
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微型营养评价对高龄住院病人生存结局的预测价值研究()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2024年06期
页码:
321-328
栏目:
论著
出版日期:
2024-12-10

文章信息/Info

Title:
The predictive value of mini-nutritional assessment on survival outcome of elderly inpatients
作者:
周文婷1; 侯韦莲1; 李 毅1; 2
1.中国科学技术大学附属第一医院（安徽省立医院），临床营养科，安徽合肥230001；2.中国科学技术大学附属第一医院（安徽省立医院），老年医学科，安徽合肥230001
Author(s):
ZHOU Wen-ting1;  HOU Wei-lian1;  LI Yi1; 2
1. Department of Clinical Nutrition, The first affiliated hospital of University of Science and Technology of China, Hefei 230001, Anhui, China；2. Department of Geriatrics, The first affiliated hospital of University of Science and Technology of China, Hefei 230001, Anhui, China
关键词:
MNA ; ACCI ; 营养不良 ; 全因死亡
Keywords:
MNA;  ACCI;  Malnutrition;  All-cause death
分类号:
R459.3
DOI:
10.16151/j.1007-810x.2024.06.001
文献标志码:
A
摘要:
目的：探究微型营养评价量表（MNA）对高龄住院病人全因死亡的预测价值。 方法：回顾性调查2016年1月1日至2020年12月31日期间于中国科学技术大学附属第一医院老年科住院的80岁及以上的部分高龄病人，通过医院病历系统获取病人临床指标，包括人口学资料、生化检查、年龄校正查尔森合并指数（ACCI）、MNA评估等指标，通过查阅病例或电话随访等方式获取病人生存结局，随访时间为3年，截至2023年12月31日，主要结局为全因死亡；K-M法绘制生存曲线，采用COX比例风险模型探究病人全因死亡风险的影响因素，绘制MNA评估预测病人全因死亡的受试者工作曲线（ROC）。 结果：根据MNA评估，营养不良、营养不良风险及营养良好的病人占比分别为56.41%(88/156)、28.85%(45/156)和14.74%(23/156)。单、多因素COX分析结果表明MNA、ACCI是病人全因死亡的独立危险因素；营养状态越差，病人预期生存期越短；MNA 预测高龄病人全因死亡曲线下面积为0.816，敏感度为 0.780，特异度为 0.906，最佳截点值为 19.25 分，提示 MNA 超过 20 分，病人全因死亡风险明显增加。 结论：高龄老年住院病人营养不良比例较高，MNA可以作为预测病人死亡的独立预测因子，建议80岁以上高龄老人MNA截点值设为20分，即MNA得分低于20分即为营养不良；临床上可根据MNA评估提前对病人进行营养干预以期获得最佳生存结局。
Abstract:
Objective: To explore the predictive value of the Miniature Nutritional Assessment (MNA) for allcause death of elderly inpatients. Methods: To investigate retrospectively the patients over 80 years old who were hospitalized in the geriatrics department of our hospital from January 1, 2016 to December 31, 2020. The clinical indicators of patients were obtained through the hospital case system, including demographic data, biochemical examination, age adjusted Charlson combined index (ACCI), MNA evaluation, and other indicators. The clinical outcomes of patients were followed up by consulting cases or telephone calls. The follow-up time was 3 years until December 31, 2023, and the primary outcome was all-cause death. The Kaplan-Meier plot was used to draw the survival curve, the COX proportional hazard model was used to explore the risk factors of all-cause death, and the receiver operating characteristic curve of MNA was drawn to evaluate and predict all-cause death of patients. Results: According to MNA evaluation, the malnutrition rate was 56.41% (88/156), the nutritional risk rate was 28.85% (45/156), and the good nutrition rate was 14.74% (23/156). Univariate and multivariate analysis showed that MNA and ACCI were independent risk factors for all-cause death. The worse the nutritional status, the shorter the expected survival time of patients. The area under the receiver operating characteristic curve predicted by MNA is 0.816, the sensitivity is 0.780, the specificity is 0.906, and the best cut-off point is 19.25; that is, MNA exceeds 20, which predicts the increased risk for all-cause death. Conclusion: The proportion of malnutrition in elderly inpatients is high, and MNA can be used as an independent predictor of death. It is suggested that the cut-off point of MNA should be set at 20 for older people over 80; that is, the MNA score below 20 is malnutrition. Clinically, nutritional intervention can be carried out in advance according to MNA evaluation to obtain the best clinical outcome.

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备注/Memo

备注/Memo:
作者简介 ：周文婷，营养师，营养学硕士，主要从事住院病人营养支持工作和临床研究。E-mail：896787890@qq.com通讯作者 ：李 毅，E-mail: 1203699464@qq.com
更新日期/Last Update: 1900-01-01