Analysis Of Nutritional Status Survey And Clinical Outcomes Of Hospitalized And Discharged Patients In General Surgery

Objective NRS 2002, SGA, MNA and NRI are used to screen nutritional risk of general surgery hospitalized patients in General Hospital of Tianjin Medical University, then to compare their applicability and consistency and analyze the effect in clinical outcomes of NRS results with respect to each tool, and using NRS 2002 and SGA to survey nutritional status of discharged patients and observe the variation of nutritional risk and malnutrition rate of hospitalized patients. Meantime, to analyze the effects of variation of nutritional status of inpatients on clinical outcomes.Methods To screen and evaluate nutritional risk of patients by NRS 2002, SGA, MNA and NRI, respectively, on the second hospital day, using NRS 2002 and SGA to screen and evaluate nutritional risk of patients on the second day before discharge,and to measure the weight, hand-grip, upper arm girth, calf girth, and clinical biochemical index. To analyze the research data by SPSS21.0, compare the consistency of NRS results with respect to the four tools and analyze the effect of NRS results on clinical outcomes.Results1. The applicability of hospital NRS2002, SGA, MNA and NRI were91.91%,91.91%,91.91% and 91.18%, respectively. The applicability of discharged NRS 2002 and SGA were 90.44% and 88.97%, respectively. The double-evaluated applicability of hospital and discharged SGA was 88.97%. The evaluations of patients’ NRS corresponding to different four tools have consistency. Let BMI≤18.5or ALB≤30g/L be one standard of malnutrition, the consistency of four evaluation tools and the standard was poor.2. To compare the hospital and discharged nutritional status of different age groups, the difference between patients whose age≥65 and patients whose age <65was statistically significant, and the NRS results of patients who were larger than 65 years old were not good. To compare the hospital and discharged nutritional risk(ormalnutrition) rates of different age groups, the difference was statistically significant.It implied that the older patient had the larger possibility of nutritional risk(or malnutrition).3.To compare the nutritional status of patients with and without malignant tumors by chi-square test, the difference was statistically significant. That is, the nutritional risk and malnutrition rate of patients with malignant tumors were higher.4. To compare the weight, hand-grip, upper arm girth, calf girth in hospitalization and discharging, the differences were not statistically significant. NRS2002 and SGA were used to compare the rates of nutritional risk and malnutrition of patient in hospitalization and discharging, the result was that the latter was lower than the former.5. The information with respect to nutritional support in hospitalization: Clinical no nutritional support patients were 28%, nutritional support patients accepted single PN, single EN and the union of PN and EN were 57.6 %, 2.4 %, and 12 %,respectively. Nutritional support of NRS2002 for nutritional risk patients were 80%,and Nutritional support of SGA for malnutrition patients were 83.3%.6. Clinical outcomes: According to the NRS results of four nutritional screening tools, giving the nutritional support for the nutritional risk(or malnutrition) patients not only can improve the nutritional status of patients but also could short the length of stay in ICU and hospitalization time significantly.Conclusion1. The four nutritional evaluation tools can be applied to the screening of malnutrition in General Surgery, NRS2002 also can be used to screen the nutritional risk of patients. The evaluations of nutritional risk of patients corresponding to different four tools had consistency. The effects of screening results of NRS2002 and SGA on clinical outcomes were most closely related. Then, it is suggested that combining the application of NRS2002 and SGA, find the nutritional risk in time, and improve the ability of prediction of undesirable clinical outcomes.2. If patients are elder than 65 year old, the elder patient has the larger possibility of nutritional risk(or malnutrition). The nutritional risk and malnutrition rate of patients with malignant tumors were higher.Thel ength of stay in ICU and hospitalization time of patients with nutritional risk were extended, then the hospitalization expense was higher. Giving the nutritional support for the nutritional risk patients not only can improve the nutritional status of patients, the most important is that it can improve the clinical outcomes and regulate the application, then the benefit is better.3. The rate of nutritional risk and malnutrition of patient on admission was lower than the rate of nutritional risk and malnutrition of patient on discharge, but the rate of nutritional risk and malnutrition of discharged patient was still high, it needs to pay enough attention to the nutritional status of discharged patients. The evaluation of nutritional status of discharged patients provides a basis to accept nutritional intervention, and it is advised to establish nutritional clinics and make the nutritional plan for the outpatients regularly, it is good for earlier recovery of patients to have a healthful diet and the way of life.