施設入所高齢者の栄養状態と身体機能

施設入所高齢者の栄養状態と身体機能、入院回数・期間、死亡率を調査した論文を紹介します。

Lin SJ, Hwang SJ, Liu CY, Lin HR. The relationship between nutritional status and physical function, admission frequency, length of hospital stay, and mortality in old people living in long-term care facilities. J Nurs Res. 2012 Jun;20(2):110-21.

結果ですが、身体機能は下腿周囲長と有意な関連を認めました。入院は経鼻経管使用と、食事パターンは下腿周囲長、アルブミン値、コレステロール値と有意な関連を認めました。栄養状態、下腿周囲長、アルブミン値、コレステロール値は入院と関連がありました。

経鼻経管患者は経口摂取患者より入院期間が長かったです。栄養状態が悪い場合、死亡リスクが高くなりました。以上より、施設入所高齢者の栄養状態により注意を払うべきだという結論です。

抄録しか読んでいませんが、この研究のリサーチクエスチョン（PECO）や研究デザインはよくわかりません。日本の学会発表レベルでありがちなものを論文にしたという印象です。PECOが明確であれば、よりよい論文になったのではないかと思います。

Abstract

BACKGROUND:

Nutrition is an important issue for elderly residents of long-term care facilities (LTCFs). About 20% of elderly LTCF residents in Taiwan are malnourished.

PURPOSE:

This study investigated correlations between nutritional status and physical function, admission frequency, hospitalstay duration, and mortality in elderly LTCF residents.

METHODS:

Researchers used a retrospective study design and convenient sampling to enroll 174 subjects aged 67 to 105 years (average, 82.5 years) who were living in legally registered LTCFs in Beitou District, Taipei City, Taiwan. A review of LTCF resident files provided data on subjects' demographics, physical examination laboratory results for the most recent 1-year period, anthropometry, physical function, admission frequency, hospital stay duration, and causes of admissions. Subjects had lived in their LTCF for more than 1 year before their enrollment date. Subjects who died during and after the study period were also included in analysis.

RESULTS:

Results showed significant changes over the study year in subjects' nutritional status, physical function, and calf circumference. Physical function was found significantly correlated with calf circumference, hospitalization status was found correlated with nasal-gastric tube feeding status, and eating pattern was found correlated with calf circumference and levels of both serum albumin and cholesterol. Nutritional status, calf circumference, albumin level, and cholesterol level also correlated significantly with hospitalization status. In this study, the likelihood of hospitalization increased with age and nasal-gastric tube feeding use. Hospital stay duration for subjects receiving nasal-gastric tube feeding was longer than that for those receiving oral feeding. Also, weak nutritional status scores for calf circumference and hemoglobin levels were factors associated with increased mortality risk.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE:
Findings recommend that greater attention should be paid to the nutritional status of elderly persons living in LTCFs to reduce hospitalization and death risks, cut medical expenses, and improve quality of care.