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Pneumologie 2014; 68(07): 478-482
DOI: 10.1055/s-0034-1365737
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

„Nutritional Risk Screening 2002“ in der Hand des Pneumologen

“Nutritional Risk Screening 2002”– in Clinical Pneumology
C. Priegnitz
1   Institut für Pneumologie an der Universität Witten Herdecke (Prof. Dr. med. Winfried J. Randerath), Krankenhaus Bethanien gGmbH, Solingen
,
W. Galetke
2   Krankenhaus der Augustinerinnen, Köln
,
M. Treml
1   Institut für Pneumologie an der Universität Witten Herdecke (Prof. Dr. med. Winfried J. Randerath), Krankenhaus Bethanien gGmbH, Solingen
,
W. J. Randerath
1   Institut für Pneumologie an der Universität Witten Herdecke (Prof. Dr. med. Winfried J. Randerath), Krankenhaus Bethanien gGmbH, Solingen
› Author Affiliations
Further Information

Publication History

eingereicht 18 February 2014

akzeptiert nach Revision 23 April 2014

Publication Date:
05 June 2014 (online)

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Zusammenfassung

Mangelernährung (ME) ist ein Problem bei Krankenhauspatienten und stellt einen Risikofaktor für Morbidität und Mortalität dar.

Ziel der Studie war es, die Häufigkeit von Unterernährung und das Risiko einer ME bei konsekutiven, stationären Patienten einer pneumologischen Fachklinik zu überprüfen.

Die Unterernährung wurde mittels Body-Mass-Index (BMI), das ME-Risiko mittels „Nutritional Risk Screening 2002“ (NRS) überprüft und in Bezug auf Alter, Geschlecht, Dauer des Krankenhausaufenthaltes und der pneumologischen Erkrankung untersucht.

Das NRS wurde bei 680 von 705 Patienten überprüft. Es zeigte bei 14,3 % ein ME-Risiko. Bei 689 Patienten wurde der BMI bestimmt, bei 2,5 % lag eine Unterernährung vor. Bei den über 65-jährigen (n = 326) war das NRS in 19,6 % der Fälle positiv, der BMI (< 18,5 kg/m²) in 1,5 %. Alter stellte einen signifikanten Risikofaktor für ein ME-Risiko dar (OR 1,054 pro Lebensjahr), das Geschlecht nicht.

In einer Subanalyse zeigte sich bei Pneumonie- und COPD-Patienten ein ME-Risiko in 23 % bzw. 16 %. Tumorpatienten waren häufiger von einem ME-Risiko betroffen, Patienten mit einer schlafbezogenen Atmungsstörung (SBAS) seltener (OR 2,33 bei Tumor, OR 0,04 bei SBAS). Ein ME-Risiko war mit einem signifikant längeren Krankenhausaufenthalt assoziiert (10,2 ± 9,5 vs. 5,4 ± 6,0 Tage).

Das NRS erweitert neben dem BMI die Beurteilung einer ME.

Abstract

Malnutrition is a frequent problem for hospitalized patients. It is a relevant risk factor for morbidity and mortality.

The aim of this study was to detect undernutrition and the risk of malnutrition (RM) in patients admitted to a university-affiliated respiratory care clinic. Undernutrition was assessed by body mass index (BMI < 18.5 kg/m²) and RM by using the “Nutritional Risk Screening 2002” (NRS 2002) in 705 consecutive patients (BMI: measured in 689 patients/NRS: 680 patients assessed).

Data was analysed with regard to age, sex, length of hospital stay as well as underlying pneumological disorders. In 14.3 % of 680 patients, RM was detected by NRS. In 2.5 % out of 689 patients, undernutrition was identified by BMI. In patients older than 65 years (n = 365), these numbers were 19.6 % (NRS) and 1.5 % (BMI < 18.5 kg/m²). Age was a significant risk factor for RM (OR 1.054 per year). Gender, however, was not associated with undernutrition or RM.

In a sub-analysis, RM was more frequent in patients with pneumonia and chronic obstructive lung disease (23 % and 16 %, respectively).

Patients with cancer were more frequently at RM as compared to patients with sleep-disordered breathing (OR: 2.33 in cancer, OR: 0.04 in sleep-disordered breathing). RM was associated with a significant increase in length of hospital stay (10.2 ± 9.5 vs. 5.4 ± 6.0 days).

Besides the BMI, the NRS provides a valid tool for screening patients at RM.

 

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