Abstract | Cilj istraživanja: Cilj istraživanja bio je istražiti nutritivni rizik hospitaliziranih bolesnika u Klinici za unutarnje bolesti, KBC-a Split, s posebnim osvrtom na bolesnike s malignim bolestima. Također, cilj je bio analizirati koji su prediktori nutritivnog rizika hospitaliziranih bolesnika s malignom bolesti.
Materijali i metode: Istraživanje je provedeno na 114 ispitanika medijana dobi 66 godina (u rasponu od 20 do 87 godina), od kojih je 60 (52,6%) muškaraca i 54 (47,4%) žena. Za svakog ispitanika zabilježeni su: dob, spol i antropometrijski parametri. Također, prikupljeni su i podatci o postojanju pridruženih bolesti, podatci o navikama pušenja te podatci o nutritivnoj potpori prije hospitalizacije. Glavne mjere ishoda bile su: indeks tjelesne mase (ITM), serumske vrijednosti ureje, glukoze, kolesterola, albumina, kreatinina i C - reaktivnog proteina. Za procjenu nutritivnog rizika korišten je NRS-2002 (inicijalni i finalni probir).
Rezultati: Malignu bolest ima 41 (36%) ispitanik. Među ispitanicima s malignom bolesti nutritivnu potporu uzima 41,6% ispitanika. Prema NRS zbroju, pod nutritivnim rizikom (finalni NRS zbroj ≥ 3) je 43,9% ispitanika, od kojih je 68,3% koji boluju i od maligne bolesti (P<0,001). Medijan NRS inicijalnog (P=0,005) i konačnog probira (P<0,001) imaju značajno viši ispitanici koji boluju od maligne bolesti. Rezultati su pokazali da su starija životna dob (P=0,02), manji ITM (P=0,006), manji opseg struka (P=0,04), manji opseg nadlaktice (P=0,002) i prisutnost KBB (P=0,04) značajni prediktori za nastajanje nutritivnog rizika u hospitaliziranih bolesnika s malignom bolesti. Starija životna dob i manji opseg nadlaktice su dva nezavisna prediktora za nastajanje nutritivnog rizika (P<0,001) ove populacije bolesnika.
Zaključak: Rezultati istraživanja su pokazali visoku učestalost malignih bolesti među hospitaliziranim bolesnicima te nisku učestalost uzimanja nutritivne potpore među hospitaliziranim bolesnicima sa i bez malignih bolesti. Starija životna dob i manji opseg nadlaktice dva su nezavisna prediktora za nastajanje nutritivnog rizika u hospitaliziranih bolesnika s malignom bolesti. Rezultati ukazuju na potrebu procjene nutritivnog rizika hospitaliziranih bolesnika, posebno starijih bolesnika s malignim bolestima. dojke imale podjednaku mineralnu gustoću kosti i trabekularnu strukturu kosti u odnosu na zdrave, postmenopauzalne žene. Rizik prijeloma u bolesnica liječenih zbog karcinoma dojke bio je jednak riziku prijeloma zdravih, postmenopauzalnih žena. Daljnja istraživanja s većim uzorkom su potrebna kako bi se mogli donositi zaključci. |
Abstract (english) | Objectives: The aim was to investigate the nutritional risk of hospitalized patients at the Internal Medicine Clinic, Clinical Hospital Center Split, with special reference to patients with malignant diseases. Also, the aim was to analyze what are the predictors of nutritional risk of hospitalized patients with malignant disease.
Material and Methods: The study included 114 participants with a median age of 66 years (ranging from 20 to 87 years), of whom 60 (52.6%) were men and 54 (47.4%) were women. For each patient following data were recorded: age, sex and anthropometric parameters. Also, data on the existence of associated diseases, data on smoking habits and data on nutritional support before hospitalization were collected. The main outcome measures were: body mass index (BMI), serum urea, glucose, cholesterol, albumin, creatinine and C - reactive protein. NRS-2002 (initial and final screening) was used to assess nutritional risk.
Results: The results showed that 41 (36%) participants have malignant disease. Among the participants with malignant disease, 41.6% participants receive nutritional support. According to the NRS sum, 43.9% of participants are at nutritional risk (final NRS sum ≥ 3), of which 68.3% suffer from malignant disease (P<0.001). The median NRS of initial (P=0.005) and final screening (P<0.001) is significantly higher in participants suffering from malignant disease. The results showed that older age (P=0.02), lower BMI (P=0.006), smaller waist circumference (P=0.04), smaller upper arm circumference (P=0.002) and the presence of CKD (P=0.04) are significant predictors of nutritional risk in hospitalized patients with malignant disease. Older age and smaller upper arm circumference are two independent predictors of nutritional risk (P<0.001) among this patient population.
Conclusions: The results of the study showed a high frequency of malignant diseases among hospitalized patients and a low frequency of taking nutritional support among hospitalized patients with and without malignant diseases. The older age and smaller upper arm circumference are two independent predictors of nutritional risk in this patient population. The results indicate the need to determine the nutritional risk of hospitalized patients, especially elderly patients with malignant diseases. |