Investigation On Nutritional Status Of Elderly Inpatients In National Large Hospitals

Background:Protein-energy malnutrition in elderly inpatients are common, which may lead many adverse consequences, such as immune function and anti-infective function decline, significantly higher incidence of postoperative complications or mortality. Clinical nutritional support can improve clinical outcomes, shorten hospital stays and reduce medical costs for patients with existing malnutrition or nutritional risk. There are different views on the standards and which tools to choose for the nutritional assessment of elderly inpatients, and so far there is still lack of comprehensive evaluation data on the incidence of the malnutrition and risk of malnutrition(nutritional risk) among elderly inpatients.Objectives:To investigate the nutritional status and to explore the more suitable nutritional assessment methods for elderly population in China, a nationally wide cross-sectional survey in elderly inpatients with NRS2002and MNA-SF was performed.Methods:We select elderly inpatients from geriatrics involved departments of30large hospitals about among14districs as the objects of our study,and8675patients were enrolled from March1,2012to April15,2012. For eligible subjects, we record their general information of demographics, take physical examination, questionnaires and accept these information in a timely manner. Their nutritional status were evaluated by the two methods.①Malnutrition standard:BMI≤18.5kg/m2, and combined with general condition; determined with ALB<30g/L if we can not obtain a valid BMI; the MNA-SF score ranging from0to7points.②utritional risk standard:the NRS2002score≥3.③Malnutrition risk:the MNA-SF score ranging from0to11points. The data collected was submitted to statistical analysis to acquire the incidence of malnutrition and nutritional risk (malnutrition risk) in elderly inpatients. Results:Among those enrolled population,8582cases had scores of NRS2002and MNA-SF at the same time, and the applicability of98.93%. The ratio of male to female is1.51:1, with average age of74.73±7.04years old, BMI applicability of85.19%. According to the NRS2002standard, the overall incidence of malnutrition is10.14%and nutritional risk is46.42%. And according to the MNA-SF standard, the overall incidence of malnutrition is15.50%and malnutrition risk is50.12%.With age increasing, anthropometric indicators of BMI, grip strength, the CC, the MAC shrinked gradually, statistically significant with incomplete group differences. The NRS2002malnutrition rate rose from8.91%and gradually increased to17.53%, the nutritional risk rate from31.42%to57.08%; the MNA-SF malnutrition rose from10.81%to33.05%, the occurrence of risk of malnutrition from43.29%increased to72.10%.Gastroenterology had highest incidence of malnutrition and nutritional risk (NRS2002,20.26%and64.66%; the MNA-SF,22.09%and65.98%); respiratory medicine took the second place (NRS2002,17.20%and58.26%; the MNA-SF,20.96%and63.36%); in third place were general surgery (NRS200211.30%and53.74%) and geriatrics (the MNA-SF,20.33%and53.50%);a lowest incidence was observed in Cardiology (NRS2002, malnutrition,20.26%;5.84%and32.40%of the MNA-SF) and orthopedic (NRS2002nutrition risk22.88%).Conclusion:In elderly inpatients, anthropometric indicators of BMI, grip strength, the CC, the MAC decreased with age increasing. Using the eveluation NRS2002and the MNA-SF, malnutrition and nutrition risk (malnutrition risk) are commonly encountered in elderly inpatients, and the incidence rose with age increasing. The incidence varies greatly among different clinical departments, this may be highly associated with the characteristics and severity of diseases. Both of NRS2002and the MNA-SF tools are simple, noninvasive, good operability, and high applicability, are suitable for elderly inpatients.