Sažetak | Cilj:
Utvrditi prevalenciju nutritivnog rizika i prevalenciju pothranjenosti bolesnika hospitaliziranih na Zavod gastroenterologije KBC-a Split u periodu od 15. siječnja do 15. lipnja 2015. godine.
Materijal i metode:
Istraživanje je provedeno na uzorku od 120 pacijenata u periodu od 15. siječnja do 15. lipnja 2015. godine. Uključeni su pacijenti sa dijagnozama upalnih bolesti crijeva (ulceroznog kolitisa i Crohnove bolesti), malignim bolestima probavnog sustava, vrijedom i GERB-om, jetrenom cirozom te akutnom i kroničnom upalom gušterače. Nutritivni status procijenjen je na osnovu antropometrijskih i biokemijskih pokazatelja te anketnog upitnika NRS-2002, a dobivene varijable su statistički obrađene.
Rezultati:
Prevalencija nutritivnog rizika procijenjena anketom NRS-2002 je 48,3%. Najveća prevalencija nutritivnog rizika procijenjena je kod pacijenata s malignim bolestima (62,9%), upalnim bolestima crijeva (57,1%), upalom gušterače (53,3%), GERB-om i vrijedom (38,2%) i jetrenom cirozom (26,7%). Prevalencija pothranjenosti procijenjena na osnovu ITM je 18,4%. Najveća prevalencija pothranjenosti zabilježena je u pacijenata sa upalnim bolestima crijeva (30,8%), malignim bolestima probavnog sustava (25,9%), GERB-om i vrijedom (17,7%), jetrenom cirozom (13,4%) te upalom gušterače (10,0%). Pothranjeni pacijenti, sa nižim ITM, u prosjeku su više gubili na tjelesnoj masi u posljednja 3 mjeseca (r= -0,425; P<0,01) i imali su veći NRS zbroj (r=-0,381; P<0,01), a manji opseg struka (r=0,773; P<0,01), opseg bokova (r=0,799; P<0,01), omjer opsega struka i bokova (r=0,424; P<0,01), debljinu kožnog nabora (r=0,277; P<0,01), opseg nadlaktice (r=0,714; P<0,01), opseg mišića nadlaktice (r=0,665; P<0,01), AST (r=0,199; P<0,05) i ALT (r=0,209; P<0,05).
Zaključak:
U našem istraživanju identificirali smo dvije skupine pacijenata koji imaju visok rizik za pothranjenost i visoku prevalenciju pothranjenosti: bolesnici s upalnom bolesti crijeva i malignomima probavnog sustava. Stoga zaključujemo da je prehrambena evaluacija osobito potrebna kod tih skupina gastroenteroloških bolesnika. U cilju smanjenja pothranjenosti poželjno bi bilo uvesti procjenu nutritivnog statusa u rutinsku kliničku praksu kod svih hospitaliziranih pacijenata. |
Sažetak (engleski) | Objectives: To establish the prevalence of nutritive risks as well as the prevalence of malnutrition in patients hospitalised in the Gastroenterology department of the Clinical hospital centre in Split from January 15 until June 15 2015. Material and Methods: This research was carried out on a sample of 120 patients from January 15 until June 15 2015. It included patients diagnosed with inflammatory bowel diseases (ulcerative colitis and Crohn's disease), malignant diseases of the digestive system, ulcers and GERD, cirrhosis of the liver and both chronic and acute pancreatitis. The nutritive status is assessed on the basics of anthropometric and biochemical indicators as well as the NRS-2002 survey and the obtained variables have been statistically processed. Results: The NRS-2002 survey shows a 48,3% prevalence of nutritive risk. The greatest prevalence of nutritive risk is estimated in patients with malignant diseases (69,9%), intestinal inflammations (57,1%), pancreatitis (53,3%), GERD and ulcers (38,2%) and cirrhosis (26,7%). The prevalence of malnutrition estimated by BMI is 18,4%. The greatest prevalence of malnutrition was recorded in patients with intestinal inflammations (30,8%), malignant diseases of the digestive system (25,9%), GERD and ulcers (17,7%), cirrhosis (13,4%) and pancreatitis (10,0%). Malnourished patients with a lower BMI, on average, lost more body mass in the last 3 months (r= -0,425; P<0,01) and had a greater NRS score (r=-0,381; P<0,01), and a smaller waist (r=0,773; P<0,01) and hip circumference (r=0,799; P<0,01), as well as a smaller waist-hip ratio (r=0,424; P<0,01), skin fold thickness (r=0,277; P<0,01), upper arm circumference (r=0,714; P<0,01), and circumference of the upper arm muscles (r=0,665; P<0,01), AST (r=0,199; P<0,05) and ALT (r=0,209; P<0,05). In our research we have identified two groups of patients who have a high risk of malnutrition and a high prevalence of malnutrition: patients with inflammatory bowel diseases and patients with malignant diseases of the digestive tract. From that we can draw a conclusion that nutritive evaluation is necessary among these groups of gastrointestinal patients. In order to prevent malnutrition it would be desirable to introduce an assessment of nutritive status into routine clinical practice with all hospitalised patients. |