加拿大住院患者的营养不良情况严重：在三级医疗中心使用营养不良通用筛查工具检测住院患者的营养不良风险

　　背景：营养不良常见于加拿大住院患者，但在加拿大整个系统的营养不良筛查非强制性。

　　目的：我们的目的是通过采用营养不良通用筛查工具（MUST）明确安大略汉密尔顿主要三级医疗中心营养不良风险的医院患病率，以确定在加拿大进行医院普遍筛查的可行性。

　　方法：在获得研究伦理审批后，我们安排了临床营养支持小组对麦克马斯特（McMaster）大学汉密尔顿医疗集团（Hamilton Health Sciences）朱拉文斯基（Juravinski）医院（一家大型学术型综合性医院）所有的患者进行MUST筛查，。

　　结果：共有315例患者入组，其中女性160例（占51%），男性155例（占49%），平均年龄71岁。我们发现31%的患者营养不良风险较高，14%的营养风险中等，与文献报道的营养不良风险比例一致。营养师和全职实习医师的调查结果表明MUST使用简单、易于操作，他们获得了病区主管的支持。所有受访者都认为筛查是有用的，他们愿意反复使用。

　　结论：MUST是了解加拿大住院患者营养不良风险医院患病率的一个简单、有效方法。进行系统的营养筛查将获得营养诊疗最佳实践，使关键利益相关者和决策者都参与其中。营养筛查将使我们更有效地利用营养资源，使管理者重视解决营养护理的不足，并建立一个基准以衡量将来营养干预的效果。

Nutr Clin Pract. 2015;30(5):709-13.

Malnutrition Matters in Canadian Hospitalized Patients: Malnutrition Risk in Hospitalized Patients in a Tertiary Care Center Using the Malnutrition Universal Screening Tool.

Rahman A, Wu T, Bricknell R, Muqtadir Z, Armstrong D.

Western University, London, Canada.

McMaster University, Hamilton, Canada.

BACKGROUND: Malnutrition is common in Canadian hospitalized patients, yet system-wide malnutrition screening is not mandatory in Canada.

AIMS: Our goal was to define the point prevalence of malnutrition risk at a major tertiary care center in Hamilton, Ontario, using the Malnutrition Universal Screening Tool (MUST) to determine feasibility of hospital-wide screening in the Canadian context.

METHODS: After research ethics approval was obtained, we arranged for a clinical nutrition support team to conduct the MUST screening on all inpatients at Hamilton Health Sciences, Juravinski site, a large academic acute care hospital.

RESULTS: A total of 315 patients were included (female, n = 160 [51%]; male, n = 155 [49%]; average age, 71 years). We identified 31% at high risk for malnutrition and 14% at medium risk, keeping with reported rates of malnutrition in the literature. Survey of dietitians and interns indicated that the MUST was easy to use and perform and that they had support of their unit supervisors. All respondents thought that the screen was useful and they wanted to repeat it.

CONCLUSION: The MUST is an easy and efficient way to define point prevalence of malnutrition risk in Canadian hospitalized patients. Moving to system-wide nutritional screening will bring about the best practices in nutrition care with the involvement of key stakeholders and decision makers. Nutritional screening will allow us to utilize nutrition resources more efficiently, engage administrators in addressing shortfalls in nutrition care, and form a baseline for which to measure the efficacy of future nutritional interventions.

KEYWORDS: hospitalization; malnutrition; nutrition assessment; nutritional support; screening

PMID: 26253124

DOI: 10.1177/0884533615598954