骨折患者术前营养风险及相关因素调查

目的：调查骨折患者术前营养风险及其相关因素。方法采用定点连续抽样，选择4650例骨折患者为研究对象，入院48 h内分别进行NRS2002营养风险筛查；其中不能获得BMI的患者，根据血清白蛋白含量进行评定。结果营养风险平均发生率为21.98%，其中男性为24.52%，女性为18.17%，男女比较差异有统计学意义（P＜0.0001）；老年患者营养风险的发生率高于中青年患者，且两组比较差异有统计学意义（P＜0.0001）；除上肢骨折与下肢骨折、颈椎骨折与胸腰椎骨折、胸腰椎骨折与骨盆骨折之间差异无统计学意义，其余骨折部位之间的两两比较，差异均有统计学意义（P＜0.003）；是否伴有其他慢性病史的患者营养风险的发生率分别为40.70%和16.67%，两组差异有统计学意义（P＜0.0001）。自变量（年龄、骨折部位和慢性病史）与营养风险的多元相关系数（R）为0.847，决定系数（R2）为0.717，P＜0.0001，回归模型整体解释变异量达到显著水平。其中年龄和慢性病史分别与营养风险的 OR 值分别是10.662和3.431。结论颈椎骨折、胸腰椎骨折、骨盆骨折和两处以上骨折患者存在较高的营养风险，并且“60岁以上”和“伴有慢性病史”都是营养风险的影响因素。

The investigation of nutritional risk and related factors in patients with fracture before the operation

ObjectiveTo investigate the nutritional risk and related factors in patients with fracture before the operation.MethodsBy using the method of continuous sampling, there were 4650 cases of fractures in patients with nutritional risk screening NRS2002 within 48 hours of admission.Patients who cannot obtain BMI were considered the nutritional risk, if their serum albumin content was less than 30 g/L.ResultsNutritional risk average occurrence rate was 21.98%, that of the male was 24.52%, female 18.17%, and the difference between men and women was statistically significant（P〈0.0001）. Occurrence of nutritional risk in elderly patients was higher than that in the young patients, and there was significant difference between two groups （P〈0.0001）. In addition to upper limb fracture and fracture of lower limb, cervical spine fracture and fracture of thoracic and lumbar spine, thoracic and lumbar fractures and fractures of the pelvis were no statistical significance.Compare of the rest of the fracture site, the differences were all statistically significant （P〈0.003）. The difference of incidence rate of nutritional risk between the patients with other chronic disease and those without it was statistically significant（P〈0.0001）. Because the multiple correlation coefficient（R） between the variables （age, fracture and chronic disease） and nutritional risk was 0.847 and the coefficient of determination（R2） was 0.717,P〈0.0001, the regression model could be established. Calculated using nutritional risk, theOR values of age and chronic disease were respectively 10.662 and 3.431.ConclusionNutritional risk of patients with cervical spine fracture, fracture of thoracic and lumbar spine, pelvic fracture and multiple fractures was high, and the ＂above 60 years old＂ and ＂chronic disease＂ were both the risk factors of nutritional risk.