Evaluation And Analysis Of Nutritional Status Of Hospitalized Middle-aged And Elderly Patients

Background and Objective:With the continuous development of medicine and medical philosophy, medical model has translated into bio-psycho-social model. Individualization and integration treatment has become the consensus of the medical professions. Clinical practice confirms nutritional status of patients is related to the selection of treatment scheme and patients recovery. Moreover, domestic and foreign medical experts and scholars pay more attention on the nutritional status of hospitalized patients. In this study, Nutritional status was assessed using Nutritional Risk Screening 2002 (NRS 2002) and the prevalence of malnutrition in hospitalized middle-aged and old patients was studied. We assessed that age and gender impacted on the incidence of malnutrition risk and further explored the effect of complications (cancer, COPD, diabetes, liver cirrhosis and renal failure) on malnutrition risk incidence, average days and expense of inpatients.Methods:The hospitalized middle-aged and eldly patients that were assessed were collected from Qilu Hospital of Shandong University from June,2014 to September, 2014 in cardiovascular, respiratory, digestive and urinary wards of geriatric department. According to NRS 2002, patients that conformed with inclusion criteria of the study were accepted. We recorded their general information, made up laboratory data, took physical examination and assessed inpatients nutritional status. Any patient with a total score>3 was considered to be at nutritional risk. The NRS 2002 score from 0 to 2 was considered to be free off nutritional risk. Patients with hydrothorax, ascites and edema and those would not obtained height and weight were identified at nutrition risk if ALB<30g/L. All the data obtained were analyzed by SPSS 19.0.Results:349 hospitalized middle-aged and old patients were enrolled in the survey, including 227 male,122 female. According to the results obtained after NRS 2002, 30.66% of individuals had nutrition risk. The prevalence of nutrition risk in Respiratory ward was 45.45%, significantly higher than other wards involved in this study. The nutritional support rate in patients with malnutrition risk was 39.25%. In this survey, we found that the average age, height, weight, PAB and Hb of male hospitalized patients was significant higher than female, while the differences of the BMI, ALB, TP, ward distribution and incidence of nutrition risk showed no statistical significance. We also analyzed the correlation between age and nutrition, and found the nutrition indicators (PAB, ALB and TP) of middle-aged patients significant higher than elderly while the differences of the BMI, Hb, height and weight had not obvious statistical significance. In addition, the prevalence of nutrition risk in middle-aged was much lower than those elderly. Further subgroup analysis of elderly patients showed that malnutrition risk was 12.37%,24.10%,39.24% and 48.89% in 60-69 years,70-79 years and over 80 years old respectively. Finally, we found in patients without, with one, with two or more of following diseases including tumor, renal failure (chronic hemodialysis), COPD, diabetes and liver cirrhosis, the nutrition risk was respectively 19.39%、34.90% and 65.71%. The more diseases accompanied, the longer they stayed in hospital and the more they costs.Conclusions:In this survey, the prevalence of hospitalized middle-aged and old patients was 30.66% and the rate of nutritional support is not satisfied. The incidence of nutrition risk in Respiratory ward was significantly higher than the others. Age is an independent factor for nutrition risk. More (tumor, renal failure, COPD, diabetes, and liver cirrhosis) increase nutrition risk hospitalized days and medical costs.