The Study Of The Correlation Between Nutritional Status And Clinical Outcomes In Patients With PHC

Objective:The nutritional status and nutritional support of 361 Patients with PHC were studied with Patient-generated subjective global assessment(PG-SGA), aimed to analysis of the correlation between clinical outcomes, quality of life and nutritional status.Methods: 1 The study was a descriptive research, in which Patients with PHC in The Second Hospital of Hebei Medical University during February 2013 and December 2014 were selected as the objective. 1.1 The nutritional status of the selected 361 Patients were evaluated from weight, ingestion, symptom, Physical function, stress state, Physical examination, comprehensive evaluation and relationship between disease and nutritional needs. Then the judgement about the Presence of malnutrition and the reason were made. 1.2 The relationship between mortality, length of stay, cost and quality of life and nutritional status of the selective Patients with PHC were analyzed using clinical outcomes and Quality of Life Questionnaire for cancer Patients. 2 Statistical Analysis. Continuous data were expressed as( X ±s) the mean standard deviation. After homogeneity of variance test and normality test of each group, the date Meet the normality and homogeneity of variance were compared by Student’s t test. Categorical variables were compared by the chi square test. Three independent samples were compared by one-way ANOVA, and then LSD-t test were used. Otherwise, for the date without the normality and homogeneity of variance Kruskal-Wallis H test were used. All statistical analyses were Performed using SPSS 13.0 software and P<0.05 was considered statistically significant.Results: 1 Description of nutritional status in Patients with PHC 1.1 There is a high incidence of malnutrition in Patients with PHC. Among the 361 Patients with PHC, 33 Patients PG-SGA quantitative evaluation score of 0-1(9.14%), 65 Patients score of 2-3(18.01%), 130 Patients score of 4-8(36.01%), 133 Patients score of≥9(36.84%). The Incidence of malnutrition was 72.85% with Patients score of 4. 1.2 The gender structure difference has statistical significance in groups with different levels of malnutrition(χ2=13.207, P<0.01). There were male Patients with malnutrition in this study. 1.3 The age structure difference has statistical significance in groups with different levels of malnutrition(F=5.786, P<0.05). 1.4 Most of the Patients have a normal body with a normal Body Mass Index from 18.5 to 24.9(256/361, 70.91%). Mostly of the type of medical insurance for the 361 Patients were New Rural Cooperative Medical Care(196/361, 54.29%). However there is no significant difference among the groups with different levels of malnutrition in the factors as BMI, education and medical insurance type(P>0.05). 1.5 And analysis of factors affecting the nutritional status of Patients with PHC, Performed regression analysis of influencing factors on gender, age, education, cost type, the regression coefficient of gender, age showed that were-0.550, 0.103. T, 8.825-6.272, respectively, corresponding to P<0.05, which was significance indicating that the gender, age has an impact on the level of malnutrition. 1.6 There were significant difference among the groups with different levels of malnutrition in the indicators of liver function(P<0.05) according to the PG-SGA quantitative evaluation. The severity of malnutrition were increased with the decline of TP, ALB and PA, and with the growth of ALT and T-BIL. However there were no significant difference among the groups with different levels of malnutrition in the indicators of liver function(P>0.05) according to the Pathological staging of PHC. 2 Present Situation of clinical nutritional support 2.1 The minority of Patients in this study have no ability to oral alimentation 71/361(19.67%). There is significant difference in nutritional support status on account of Present functional.(χ2=20.184, P<0.05). 2.2 The majority of Patients in this study have got different types of nutritional support(332/361, 19.67%). The types of nutritional support is not a significant factor among the groups with different level of malnutrition(χ2=7.295,P>0.05). 3 The correlation between nutritional status and clinical outcome in Patients with PHC. 3.1 Mortality. At the end of this study 335/361(92.79%) Patients were still alive, 6/361(1.66%) had died. The mortality among the groups with different level of malnutrition was not significant difference(χ2=0.417,P≥0.05). 3.2 Hospitalization and medical cost. The factors of hospitalization(F=0.577,P>0.05) and medical costs(F=0.139,P>0.05) were both not significant difference among the groups with different level of malnutrition. 3.3. Quality of life. The factors of QOL(F=33.931,P<0.01) and KPS(F=99.797,P<0.01) were both significant difference among the groups with different level of malnutrition.Conclusions:1 There was a Positive correlation between liver function and malnutrition for Patients with PHC. The indicators of liver function cloud be important index to evaluate malnutrition status.2 The factors of gender and age were significant correlated with malnutrition.3 This study indicated that the nutritional support for PHC Patients in our hospital needed further specifications, the type of nutritional support and nutrients collocation needed further investigation.4 This study indicated that nutrition status were positively corrected to the quality of live. But there is no significant correlation between nutritional status of Patients with PHC and mortality, hospitalization and medical cost.