在诊疗过程中对疾病相关营养不良的处理

　　在过去二十年中，无论是在发展中国家还是工业化国家，疾病相关营养不良发病率高得惊人，虽然在这期间医疗水平有了显著提高。特别是在拉丁美洲的医院，疾病相关营养不良的发生率更是惊人，在阿根廷、巴西、智利、哥斯达黎加、古巴、多米尼加、厄瓜多尔、墨西哥、巴拿马、巴拉圭、秘鲁、波多黎各、委内瑞拉和乌拉圭的医院中，疾病相关营养不良占成人患者的50%。无论从人力还是财力角度，疾病相关营养不良的花费都很高：感染并发症增加、压疮发生率居高不下、住院时间延长、重复入院率较高、护理花费增加以及死亡风险增加。为了引起拉丁美洲医疗体系对疾病相关营养不良的关注，成立了feedM.E.研究小组以支持对feedM.E.教育的普及。在本文中，全球研究小组即feedM.E.拉丁美洲研究小组表明营养不良对医保体系引起了过多的花费。同时，研究小组为如何合理进行营养支持以改善患者临床结局并降低医保费用提供了证据。为了使整个拉丁美洲患者获得维持健康的充足营养，本文对feedM.E.简单有效的营养支持路径用英语和西班牙语进行了阐述，从而方便其使用。

JPEN J Parenter Enteral Nutr. 2016;40(3):319-25.

Addressing Disease-Related Malnutrition in Healthcare: A Latin American Perspective.

Correia MI, Hegazi RA, Diaz-Pizarro Graf JI, Gomez-Morales G, Fuentes Gutiérrez C, Goldin MF, Navas A, Pinzón Espitia OL, Tavares GM.

Universidade Federal, de Minas Gerais, Brazil; Abbott Nutrition Research and Development, Columbus, Ohio; Hospital Angeles Lomas & Anáhuac University, Mexico City, Mexico; Abbott Nutrition, Bogotā, Colombia; Hospital Clínico Fuerza Aérea de Chile, Gral. Dr Raúl Yazigi, Santiago, Chile; Hospital Italiano Buenos Aires, Buenos Aires, Argentina; Cliníca Reina Sofía, Bogotā, Colombia; Universidad del Rosario-Méderi, Bogotá, Colombia; Centro Integrado de Atencao à Saúde, Vitória, Espirito Santo, Brazil.

Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms-increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients' clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.'s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use.

KEYWORDS: assessment; community; hospital; malnutrition; nutrition; oral nutrition supplement; screening

PMID: 25883116

PMCID: PMC4767145

DOI: 10.1177/0148607115581373