Uticaj intrahospitalnog pogoršanja nutritivnog statusa na ishod lečenja odraslih gastroenteroloških bolesnika
Sažetak
Uvod/Cilj. U dostupnoj litearturi postoji malo radova o uticaju promena nutritivnog statusa bolesnika tokom hospitalizacije na ishod lečenja. Cilj studije bio je da se kod hospitalizovanih gastroenteroloških bolesnika ispita odnos između pogoršanja nutritivnog statusa i ishoda lečenja. Metode. Kod 650 gastroenteroloških bolesnika procenjivan je nutritivni status pri prijemu i pri otpustu iz bolnice, korišćenjem šest parametara procene: indeks telesne mase, debljina kožnog nabora tricepsa, obim sredine nadlaktice, koncentarcija albumina u serumu, broj limfocita i nenamerni gubitak težine. Uticaj na ishod lečenja testiran je za: nutritivni status pri prijemu, nutritivni status pri otpustu i intrahospitalno pogoršanje nutritivnog statusa. Rezultati. Učestalost povoljnog ishoda kod nepothranjenih i pothranjenih bolesnika pri prijemu, iznosila je 93,4–97,3%, odnosno 81,2–91,2%. Učestalost povoljnog ishoda kod nepothranjenih i pothranjenih bolesnika na otpustu, bila je 94%–97,4%, odnosno 80,8–88,1%. Povoljan ishod bolesti dobijen je kod 95,6–98,9% bolesnika bez pogoršanja nutritivnog statusa i kod 87,1–90,3% bolesnika sa pogoršanjem nutritivnog statusa. Intrahospitalno pogoršanje nutritivnog srtatusa značajno je uticalo na ishod lečenja, bez obzira na to koji je parametar procene nutritivnog statusa bio primenjen (p < 0.001 za sve primenjene parametre). Osim toga, intrahospitalno pogoršanje nutritivnog statusa bilo je jedini nezavisni prediktor ishoda lečenja (multivarijantna analiza Forwald Wald, p £ 0,001; relativni rizik (RR) = 0,104–0,350; interval poverenja (IP) = 0,037–0,186/0,297-0,657). Zaključak. Pogoršanje nutritivnog statusa je nezavisni prediktor nepovoljnog ishoda lečenja.
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