{"id":117403,"date":"2018-03-11T10:46:57","date_gmt":"2018-03-11T10:46:57","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/evaluacion-del-estado-nutricional-al-ingreso-hospitalario-en-pacientes-de-edad-avanzada\/"},"modified":"2018-03-11T10:46:57","modified_gmt":"2018-03-11T10:46:57","slug":"evaluacion-del-estado-nutricional-al-ingreso-hospitalario-en-pacientes-de-edad-avanzada","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/salud-publica\/evaluacion-del-estado-nutricional-al-ingreso-hospitalario-en-pacientes-de-edad-avanzada\/","title":{"rendered":"Evaluaci\u00f3n del estado nutricional al ingreso hospitalario en pacientes de edad avanzada."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Lorena Rentero Redondo <\/strong><\/h2>\n<p>Objetivo  determinar la preValencia de desnutrici\u00f3n en pacientes con edad igual o superior a 65 a\u00f1os al ingreso hospitalario y los factores asociados a su presencia.  analizar el exceso de estancia hospitalaria (eeh), impacto econ\u00f3mico y la tasa de reingresos prematuros asociados a la desnutrici\u00f3n hospitalaria en paciente de edad avanzada. material y m\u00e9todos estudio retrospectivo realizado en el hospital universitario reina sof\u00eda. Se incluyeron todos los pacientes con edad igual o mayor a 65 a\u00f1os que ingresaron en medicina interna durante 2011. Se calcul\u00f3 el tama\u00f1o muestral teniendo en cuenta los ingresos del a\u00f1o anterior, y  considerando una preValencia de desnutrici\u00f3n  del 50% con un ic95% y un error del 5%.  para cada paciente se recogieron, de la historia cl\u00ednica informatizada,  datos demogr\u00e1ficos (sexo y edad), antropom\u00e9tricos (peso, talla, imc) y cl\u00ednicos (diagn\u00f3stico al ingreso, antecedentes patol\u00f3gicos y determinaciones anal\u00edticas de alb\u00famina, colesterol total y linfocitos). Los datos administrativos se obtuvieron (estancia hospitalaria y grd al alta) del cmbd. El coste por grd y la estancia esperada fue facilitado por el servicio de documentaci\u00f3n cl\u00ednica del hospital.  para definir el grado de desnutrici\u00f3n se emple\u00f3 la herramienta control nutricional (conut),  que establece una puntuaci\u00f3n basada en la determinaci\u00f3n alb\u00famina, colesterol total y linfocitos.   para determinar los factores asociados a la presencia de desnutrici\u00f3n moderada-grave se realiz\u00f3 un an\u00e1lisis de regresi\u00f3n log\u00edstica multivariante. para cada paciente se calcul\u00f3 el eeh, los reingresos prematuros  y el coste asociado al eeh. Para todos los an\u00e1lisis se utiliz\u00f3 un dintel de significaci\u00f3n estad\u00edstica de 0,05 y se realizaron con el paquete estad\u00edstico spss v15.0.   resultados se incluyeron 310 pacientes de los cuales el 54,2% fueron mujeres, la edad media fue de 80,1 a\u00f1os (de: 6,8), con un rango entre 65  y 95 a\u00f1os. En cuanto al diagn\u00f3stico al ingreso el 27,4% correspond\u00edan a enfermedades del aparato respiratorio, 22,6% del circulatorio y 11,6% del digestivo. La mediana del \u00edndice de charlson fue de 2,0, encontrado que el 36,8% de los pacientes presentaban una comorbilidad alta.  Las patolog\u00edas cr\u00f3nicas m\u00e1s prevalentes fueron la diabetes mellitus (44,2%), la enfermedad renal cr\u00f3nica (25,2%) y la demencia (10.6) en relaci\u00f3n con el conut, el 75,8% de los pacientes presentaban criterios de desnutrici\u00f3n: el 42,6% leve, el 28,7% moderada y el 4,5% grave, de \u00e9stos s\u00f3lo un 46,6% tuvo alg\u00fan tipo de soporte nutricional durante el ingreso. los factores asociados a la presencia de desnutrici\u00f3n moderada-grave fueron el sexo femenino (or: 1,7; ic95%: 1,1 &#8211; 2,8), edad mayor de 80 a\u00f1os (or: 2,0, ic 95%: 1,2 &#8211; 3,5), y la demencia (or: 2,4; ic95%:1,2 &#8211; 5,2). No se encontr\u00f3  asociaci\u00f3n con la comorbilidad, ni con otras patolog\u00edas cr\u00f3nicas.  respecto al eeh (d\u00edas) se encontraron diferencias entre los pacientes con desnutrici\u00f3n moderada-grave (4.7; ic95%: 2.3 &#8211; 7.1) y normonutridos (-0.1; ic95%: -1.4 &#8211; 1.2) (p=0.001),  no siendo as\u00ed para los casos de desnutrici\u00f3n leve (1.6; ic95%: 0.5-2.8) (p=0.07).  En relaci\u00f3n a la tasa de reingreso prematuros en pacientes desnutridos fue de 28\/235 (11.9%). el coste asociado al eeh\/100 pacientes fue de 195479.4 \u00c2\u00bf  para la desnutrici\u00f3n  grave moderada, 73484.8 \u00c2\u00bf  desnutrici\u00f3n leve, mientras que en pacientes normonutridos supuso un ahorro de 12353 \u00c2\u00bf.  conclusiones la desnutrici\u00f3n hospitalaria en paciente anciano sigue siendo un problema sin resolver, dada la elevada preValencia encontrada, asoci\u00e1ndose  a un exceso de estancia hospitalaria y aumento del gasto hospitalario, especialmente en pacientes con desnutrici\u00f3n moderada-severa. el conut es una herramienta de cribado nutricional de gran utilidad por la rapidez y validez de sus resultados, y permite su detectar pacientes con riesgo o alerta nutricional sin suponer un incremento de costes.    objetive to determine the prevalence of malnutrition in patients aged 65 years or more at admission and factors associated with its presence. analyze excess hospital stay (ehs), economic impact and premature readmission rate associated with hospital malnutrition in elderly patient. material and method retrospective study conducted at the university hospital reina sof\u00eda. All patients aged 65 years or older admitted to internal medicine in 2011. The sample size was calculated taking into account the income of the previous year, and considering a prevalence of malnutrition of 50% with a 95% and included error of 5%. for each patient were collected from the clinical history, demographics (sex and age), anthropometric (weight, height, bmi) and clinical (diagnosis at admission, medical history and laboratory tests albumin, total cholesterol and lymphocytes). Administrative data (grd hospital stay and at discharge) were obtained cmbd. The cost and the expected stay was facilitated by the clinical documentation hospital. to define the degree of malnutrition nutritional control tool (conut), which establishes a score based on albumin, total cholesterol and lymphocyte determination was used. to determine the factors associated with the presence of moderate to severe malnutrition analysis of multivariate logistic regression was performed. for each patient the ehs, premature readmissions and the associated cost to ehs was calculated. A threshold of statistical significance of 0.05 was used for all analyzes and were performed with spss v15.0. results 310 patients, of whom 54.2% were women were included, the mean age was 80.1 years (sd: 6.8), ranging between 65 and 95 years. Regarding diagnosis at admission 27.4% were respiratory diseases, 22.6% of the circulatory and digestive 11.6%. The median charlson index was 2.0, found that 36.8% of patients had high comorbidity. The most prevalent chronic diseases were diabetes mellitus (44.2%), chronic kidney disease (25.2%) and dementia (10.6) regarding the conut, 75.8% of patients met the criteria of malnutrition: 42.6% mild, 28.7% moderate and severe 4.5%, of which only 46.6% had some nutritional support during admission. factors associated with the presence of moderate to severe malnutrition were female gender (or: 1.7; 95%: 1.1 &#8211; 2.8), age over 80 years (or: 2,0, ic 95%: 1,2 &#8211; 3,5), and dementia (or: 2,4; ic95%:1,2 &#8211; 5,2). No association with comorbidity or with other chronic diseases was found. regarding the ehs (days) differences between patients with moderate to severe malnutrition (4.7; ic95%: 2.3 &#8211; 7.1) and normally nourished (-0.1; ic95%: -1.4 &#8211; 1.2) (p = 0.001) were found, but were not for cases of mild malnutrition (1.6, 95%: 0.5-2.8) (p = 0.07).Regarding the rate of premature readmission in malnourished patients was 28\/235 (11.9%). the cost associated with ehs \/ 100 patients was 195479.4 \u00c2\u00bf for moderate malnutrition, mild malnutrition \u00c2\u00bf 73484.8, and normally nourished patients represented a saving of \u00c2\u00bf 12,353. conclusions hospital malnutrition in elderly patients remains an unsolved problem, given the high prevalence found, associated to an excess of hospital stay and increased hospital costs, especially in patients with moderate to severe malnutrition. the conut is a nutritional screening tool very useful for the speed and validity of their results, and allows detecting patients at risk or nutritional alert without lead to increased costs.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Evaluaci\u00f3n del estado nutricional al ingreso hospitalario en pacientes de edad avanzada.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Evaluaci\u00f3n del estado nutricional al ingreso hospitalario en pacientes de edad avanzada. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Lorena Rentero Redondo <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 23\/04\/2015<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Carles Iniesta Navalon<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: jacinto Francisco Fernandez pardo <\/li>\n<li>Luis Carlos Fern\u00e1ndez lis\u00f3n (vocal)<\/li>\n<li>m. Jes\u00fas Gomez ramos (vocal)<\/li>\n<li>Juan a Mar\u00eda Morillas ruiz (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Lorena Rentero Redondo Objetivo determinar la preValencia de desnutrici\u00f3n en pacientes con edad igual o superior a [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[8607,8235,1176,967],"tags":[223553,8461,83429,231354,231355,70088],"class_list":["post-117403","post","type-post","status-publish","format-standard","hentry","category-geriatria","category-murcia","category-nutrientes","category-salud-publica","tag-carles-iniesta-navalon","tag-jacinto-francisco-fernandez-pardo","tag-juan-a-maria-morillas-ruiz","tag-lorena-rentero-redondo","tag-luis-carlos-fernandez-lison","tag-m-jesus-gomez-ramos"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/117403","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=117403"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/117403\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=117403"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=117403"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=117403"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}