Investigation Of Nutritional Status And Intervention In Senile Patients With Pneumonia

BackgroundWith the acceleration of population aging process,average life expectancy of the population has extend,the elderly health problems also become increasingly prominent.Plenty of evidence has confirmed that the elderly are at high risk of malnutrition or nutritional risk,malnutrition can lead to adverse clinical outcomes,appropriate Nutritional support therapy can improve the nutritional status of patients,promote the recovery of the disease,improve the clinical outcomes.Pneumonia is one of the main causes of morbidity and mortality in elderly,and the nutritional status of senile patients with pneumonia are easily overlooked.At present,there are few studies on nutritional status and nutritional intervention in elderly patients with pneumonia.Objective1.To Investigate the nutritional status of the elderly patients with pneumonia over 70 years old,Analysis the relationship between age,gender,infection indexes.complications and nutritional status.2.To analyze the relationship between nutritional status,nutritional support and clinical prognosis,and propose evidence for nutritional support treatment of senile patients with pneumonia.MethodThe senile patients with pneumonia(aged>70years)in the geriatrics department of Qilu Hospital of Shandong University were enrolled in this investigation from July,2015 to December,2016.The nutritional status of all the patients were assessed by the mini nutritional assessment-short form(MNA-SF)and nutritional risk screening(NRS 2002)after admission in 48h.We recorded the basic data,laboratory results,anthropometric indicators,therapeutic regimen of the patients,nutritional support had also been recorded.Comprehensive analyzed and compared the relationship between nutritional status,nutritional support and clinical outcomes.Results151 patients with pneumonia were enrolled in this survey,with an average age of 84.94±5.84 years old.According to MNA-SF standard,the incidence of nutritional risk(malnutrition risk and malnutrition)was 63.58%,According to NRS 2002 standard,the incidence of nutritional risk was 73.51%,The ratio of nutritional risk of NRS 2002 was higher than that of MNA-SF in the senile patients with pneumonia,(P<0.01).MNA-SF evaluation results showed that the nutritional risk in elderly patients with pneumonia was increased with age(P<0.01),NRS 2002 showed that with the increase of age,the incidence of nutritional risk in elderly patients with pneumonia had an upward tendency,but the difference was not statistically significant(P>0.05).According to MNA-SF and NRS 2002 results,nutritional indexes(ALB,PAB,Hb)of nutritional risk patients was lower than that of patients without nutritional risk,the level of PCT was significantly higher than that of patients without nutritional risk,the incidence of aspiration was higher than that of patients without nutritional risk,hospitalization time was prolonged in patients with nutritional risk.To analyze the complications of pneumonia,we can found the patients combined with chronic cerebrovascular disease had higher incidence of nutritional risk than that without this disease(P<0.05).NRS 2002 score also suggested that the patients with coronary artery disease had higher incidence of nutritional risk than that without this disease(P<0.05).There were 6 deaths during hospitalization,accounting for 3.97%of the total patients.In this study,the nutritional support rate was 44.37%,the nutrition support rate of patients with nutrition risk screening by MNA-SF and NRS2002 was 65.63%,57.66%,respectively.Through analysis,we found that the rate of nutritional support in elderly patients over 80 years old was significantly higher than those under the age of 80,the difference was statistically significant(P<0.05).ConclusionsThe incidence of nutritional risk is higher in senile patients with pneumonia,Complications(such as coronary Artery disease,chronic cerebrovascular disease,etc.)will affect the nutritional status of patients.The application of nutritional support in elderly patients with pneumonia is inadequate,a more standardized nutritional intervention should be given.The screening results of MNA-SF and NRS 2002 in elderly patients with pneumonia are not parallel,Whether the nutritional screening tools in the elderly need further revision is still worth exploring.