Evaluación del estado nutricional de los pacientes mayores atendidos en una unidad de hospitalización a domicilio Assessment of the nutritional status of elderly patients treated at a home-hospital unit

Abstract

Objetivos: Establecer el estado nutricional de nuestros pacientes mayores, valorar la utilidad de los distintos parámetros antropométricos y bioquímicos como marcadores de desnutrición y determinar qué variables estudiadas tienen mayor correlación con la malnutrición. Ámbito: Unidad de Hospitalización a Domicilio del Hospital Universitario Arnau de Vilanova de Lleida. Pacientes: 57 pacientes &#8805; 60 años. Media de estancia en nuestra unidad: 12,1 días. Variables: Edad, sexo, grupos según la complejidad de las curas, patología asociada, diagnóstico, motivo de ingreso, tiempo de estancia hospitalaria, intervención quirúrgica practicada, complicaciones durante la estancia en la UHD, peso, talla, PCT, CB, IMC, CMB, albúmina, hemoglobina y RTL. Resultados: Los pacientes de "más edad" presentan una tasa de seroalbúmina (p Goals. To establish the nutritional status of our elderly patients, assess the usefulness of the various anthropometric and biochemical parameters as markers of malnutrition and to determine which of the variables studied have the greatest correlation with malnutrition. Scope: Home Hospital Unit of the Arnau de Vilanova Teaching Hospital in Lerida. Patients: 57 patients &#8805; 60 years. Mean admission to our unit: 12.1 days. Variables: Age, sex, groups by treatment complexity, associated pathology, diagnosis, reason for admission, duration of stay in hospital, surgery performed, complications during the stay at the Home Hospital Unit, weight, height, PCT, AC, BMI, albumin, haemoglobin and RTL. Results: Patients of great age present lower levels of serum albumin (p < 0.005), total proteins (p < 0.001), transferrin (p < 0.03), haemoglobin (p < 0.02) and RTL (p < 0.04) than "younger" elderly patients. Serum albumin and haemoglobin are lower in patients in a complicated post-surgical condition (p < 0.04 and p < 0.02, respectively) and this group is the one with the longest stays (p < 0.001). Those patients with hypoalbuminaemia (74.1%) present lower PCT and RTL (p < 0.02) and a longer stay in hospital (p < 0.01) than those with normal levels of albumin in blood. Patients with anaemia (63.3%) present a lower RTL (p < 0.01) and a greater hospitalization time than those without anaemia. Total proteins (p < 0.0001), albumin (p < 0.004), transferrin (p < 0.003) and RTL (p < 0.005) correlate negatively with age. Albumin (p < 0.001), haemoglobin (p < 0.006) and RTL (p < 0.0001) present a negative correlation with length of hospital stay. Conclusion: The prevalence of global malnutrition is high (51% moderate-severe). The nutritional status worsens with age. The length of hospitalization increases gradually with age, with deterioration in the nutritional status and with complexity of the treatment provided