A Study On The Relationship Between Nutritional Risk Screening Status Of Hospitalized Pulmonary Tuberculosis Patients And Clinical Outcomes

ObjectivesTo investigate the prevalence of nutritional risk in hospitalized patients with pulmonary tuberculosis. Through analyzing the influence factors of the occurrence of nutritional risk and its relationship with clinical outcomes to provide a basis for improving the treatment effect of hospitalized patients with pulmonary tuberculosis. MethodsThe NRS-2002 tool was applied to screen and evaluate the nutritional risk of hospitalized patients with pulmonary tuberculosis in the respiratory department of a infectious disease hospital in Zhengzhou City from January 1, 2015 to August 31,2015. At the same time, a questionnaire survey and case data collection were conducted. According to the results of nutritional risk screening, the patients were divided into the nutritional risk group and non-risk group. Univariate analysis and multivariate logistic regression analysis was used to analyze the influencing factors of the occurrence of nutritional risk. The relationship between nutritional risk status and clinical outcome in patients with pulmonary tuberculosis was analyzed by t test and c(17) test. All data were analysed with SPSS 22 statistical software. The statistically significant level was set as α=0.05. Results1. A total of 425 hospitalized patients with pulmonary tuberculosis were screened in this study, of which 92 patients BMI <18.5, 219 patients NRS-2002 score ≥3 points. The prevalence of malnutrition and nutritional risk in hospitalized patients with pulmonary tuberculosis were 21.6% and 51.5%, respectively.2. Influencing factors of statistical significance by single factor analysis were age, degree of education, occupation, accompany diabetes, fever, poor appetite, wasting, sputum examination results, tuberculous cavity, the number of lesions involving the lung field, serum TP, serum ALB, serum CHOL, LYMPH count, serum HB, duration of onset. Influencing factors of statistical significance by unconditional logistic regression were age(OR=1.049, 95% CI=1.025-1.073), with diabetes(OR=3.252,95% CI=1.036-10.210), poor appetite(OR=6.506, 95% CI=2.885-14.672), wasting(OR=62.268, 95% CI=20.536-188.8), sputum examination result(OR=2.837, 95% CI=1.298-6.201), serum ALB(OR=0.853, 95% CI=0.784-0.929), serum CHOL(OR=0.566,95% CI=0.390-0.821).3. In the nutritional risk group, there were 66.7% patients with complications, 2 patients died, 25 patients occurred drug-induced liver injury, the average length of stay was 51.5±18.2 days, the average hospitalization costs were 29731.1±11594.1 Yuan. In the non-risk group, there were 39.3% patients with complications, no patient died, 14 patients had drug-induced liver injury, the average length of stay was 37.4±11.1 days, the average hospitalization costs were 18649.2±6898.0 Yuan. Conclusions1. The prevalence of malnutrition and nutritional risk in hospitalized patients with pulmonary tuberculosis is high.2. Influencing factors of nutritional risk included: age, accompany diabetes, poor appetite, wasting, sputum examination results, serum ALB, serum CHOL.3. The incidence of poor clinical outcomes in hospitalized pulmonary tuberculosis patients with nutritional risk is high.