영양불량 위험환자의 선별조건과 영양공급 상태의 비교연구

Abstract

The aim of this study is to identify whether the selection of patients with the risk of a bad nutrition status based on albumin, nutrition scores(NS), and diet scores is appropriate, targeting patients hospitalized in C University Hospital in Gwangju in 2014. Then this study intended to find out other conditions that are helpful for the selection of patients who did not have appropriate nutrition in addition to the three factors mentioned above. This study collected the following data on the subjects: sex, age, educational level, data from the departments they were diagnosed in as well as general characteristics; smoking, drinking, activity status, height, and weight as practices of healthy living habits; and disease history, appetite, weight change, sleeping hours, digestive disorders, data on physical symptoms of malnutrition, biochemical figures, prescribed diet programs, as well as how to provide nutrition, targeting 798 patients selected as those with a risk of a bad nutrition status. The data was analysed with the use of IBM SPSS version 21.0. To understand the general characteristics of the subjects, practices and habits of healthy living, physical status, distribution of nutritional status, and standard distribution of patients with a risk of malnutrition, a frequency test was conducted. For comparison between general characteristics of the subjects, practices of healthy living habits, physical status, nutritional status, selection criteria of patients with a risk of malnutrition, calories and protein intake in comparison with the required calories, a crosstabs test was conducted. For comparison between biochemical figures, calories and protein intake in comparison with the requirements, an independent sample t-test was conducted. A correlational analysis was conducted to examine age, Body Mass Index(BMI), Albumin, NS, diet score, calories and protein intake in comparison with the requirements. In consideration of variables which were related with calories and protein intake in comparison with requirements in the crosstabs analysis, a multiple logistic regression analysis was conducted. As a result, it was discovered that the calory intake rate in the internal medicine department was 2.46(95% CI: 1.34-4.53) compared with external medicine and the odds ratio in intake of less than 75% of caloric nutrients was significantly low. The caloric intake rate was 3.12(95% CI: 1.46-6.68) when BMI was more than 25kg/m2 compared with less than 18.5kg/m2 and the odds rate in intake of less than 75% of caloric nutrients was significantly low. As for how to provide nutrition, the calory intake rate was 0.21(95% CI: 0.11-0.40) and the odds ratio in the intake of less than 75% of caloric nutrients was significantly low. The protein intake rate of the subjects in the internal medicine department was 6.23(95% CI: 2.98-13.01) compared with the external medicine department and the odds rate in the intake of less than 75% of protein nutrients was significantly high. When BMI was more than 25kg/m2 when compared to less than 18.5kg/m2, the protein intake rate was 3.63(95% CI: 1.41-9.32) and the odds rate in intake of less than 75% of protein nutrients was significantly high. The protein intake rate of the subjects with disease history was 2.39(95% CI: 1.21-4.73) compared with those without any disease history and the odds rate in intake of less than 75% of protein nutrients was significantly high. The protein intake rate of the subjects with good appetite was 0.24(95% CI: 0.06-0.96) and the odds rate in intake of less than 75% of protein nutrients was significantly low. The protein intake rate of the subjects when enteral nutrition was combined with parenteral nutrition was 0.18(95% CI: 0.09-0.36) and the odds rate in intake of less than 75% of protein nutrients was significantly low. The protein intake rate of the subjects with a prescribed diet program was 0.20(95% CI: 0.05-0.81) in comparison with fasting and the odds rate in intake of less than 75% of protein nutrients was significantly low. Therefore, when hospitalized patients with a risk of malnutrition were selected and managed, if there are patients with variables that show a significant difference as well as albumin, NS, and diet score, their nutrition status should be continuously monitored and proper nutrition should be provided for them so that there will be no problems caused due to malnutrition.