广州地区住院患者NRS2002营养风险筛查的多中心研究

目的调查广州4所教学医院住院患者营养不足、营养风险发生率以及营养支持的应用状况，并明确营养风险发生率在性别或年龄间的差异。方法对2008年4月至2011年12月广州4所教学医院消化内科、呼吸内科、神经内科、肾内科、普外科、胸外科等6个专科符合NRS2002评定标准的2550例住院患者进行营养筛查，并调查其营养支持应用情况。结果共获取2142例（84％）的BMI值，营养不足和营养风险的发生率分别为17．8％和41．5％；6个专科中，呼吸内科患者的营养不足和营养风险发生率均最高，分别为28．2％和55．9％；≥70岁的患者营养风险发生率高于〈70岁者（64．2％US32．6％，P=0．000）；总的营养风险发生率没有性别差异。有营养风险者的营养支持率为47．6％，无营养风险者的营养支持率为19．4％。肠外营养占全部营养支持的88．7％。结论NRS2002是进行营养筛查的一个有效工具，可推荐用于新人院患者。广州住院患者中存在较高比例的营养风险或营养不足，≥70岁患者更易发生营养风险；营养治疗存在不恰当的营养干预及肠外营养的过度使用。应在精确评估患者营养状况的基础上制定合理的营养支持方案。

Multicentre analysis of nutritional risk by NRS2002 among hospitalized patients in Guangzhou area

Objective To assess nutritional status, the prevalence of nutritional risk, and nutritional support in hospitalized patients from four teaching hospitals in Guangzhou, to determine gender or age associated difference in the prevalence of nutritional risk. Methods A total of 2550 patients admitted during April 2008 to December 2011 from six departments （ Gastroenterology, Pulmonology, Neurology, Nephrology, General Surgery and Thoracic Surgery ） were screened using the Nutritional Risk Screening 2002 tool. Results Overall prevalence of undernutrition and nutritional risk was 17.8% and 41.5%, respectively. The department of pulmonology enjoyed the highest prevalence of undernutrition （ 28.2% ） and nutritional risk （ 55.9% ） . The prevalence of nutritional risk was significantly higher in ~〉 70 years old patients than patients who were 〈 70 years old （ 64.2% vs 32.6%, X2=212, P = 0.000 ） . No gender difference in the prevalence of nutritional risk was observed in general. Totally 47.6% of ＂at risk＂ and 19.4% of ＂not at risk＂ patients received nutritional support. Parenteral nutrition accounted for 88.7% of the nutritional support. Conclusions Nutritional Risk Screening 2002 is a powerful tool and should be recommended to use at admission. A large proportion of hospitalized patients were at nutritional risk or undernutrition in Guangzhou. Patients 1〉 70 were more likely to be at nutritional risk. Inappropriate assignment of nutritional interventions and unrestrained usage of parenteral nutrition were observed in nutritional therapy. Precise evaluation of a patient＇ s nutritional condition and subsequent rational assignment of nutritional support are warranted.