부산지역 일부 종합병원 입원환자의 영양불량 유병률과 관련 요인 분석

Abstract

Malnutrition is associated with increased mortality, morbidity and length of hospital stay, and several studies have been reported that hospital malnutrition presents a high prevalence. The purpose of this study was to investigate the prevalence and risk factors of malnutrition in hospitalized patients in Busan, Republic of Korea. The subjects were 944(440 men and 504 women) patients in four general hospitals(over 300 beds) in Busan from March through April, 2011. In the method, nutritional status was assessed by the Nutritional Risk Screening 2002(NRS 2002) in initial hospitalization. Data were collected from the electronic medical records system for the characteristics of the subjects, clinical outcomes, biochemical laboratory data, and nutrition support states. Clinical dietitians interviewed the patients by using structured questionnaires involved in the data on weight loss and problems related oral intakes. Malnutrition was diagnosed in 17.2% of patients. In prevalence of malnutrition between two clinical departments, internal departments had significantly(p<0.001) higher rates than those of surgical departments. Malnourished patients had significantly(p<0.001) higher ages than those of well-nourished patients, but the values of BMI, serum albumin, total cholesterol, TLC, hemoglobin, and hematocrit of malnourished patients showed significantly(p<0.001) lower than those of well-nourished patients. According to logistic regression, the main determinant factors for nutritional status were the age(OR 1.043), length of stay(OR 1.007), BMI(OR 0.782), serum albumin(OR 0.444) and total cholesterol(OR 0.994). The malnourished patients had symptoms of anorexia(31.8%), and nausea and vomiting(18.1%), but nutritional intervention was performed only 35.8% of them. In order to increase therapeutic effects of hospitalized patients, the clinical dietitians have to offer proper nutritional intervention by the results of nutrition assessment and identification of malnutrition.