Đánh giá tình trạng dinh dưỡng và các yếu tố liên quan trên bệnh nhân nặng tại Khoa Hồi sức Truyền nhiễm, Bệnh viện Trung ương Quân đội 108

Abstract

Objective: Assessment of nutritional status and related factors in severe cases before and after one week of treatment. Subject and method: A cross-sectional study was performed on 42 severe patients at Infectious Intensive care unit in 108 Military Central Hospital from July 2017 to October 2017. Result: Patients’ mean age was 66.7 ± 15.3 years; the most common diseases were sepsis (35.7%), encephalitis - meningitis (26.2%), pneumonia (16.7%); the rate of malnutrition at admission according to BMI, SGA, protein and albumin were admission 16.7%; 35.7%; 31.0% and 73.8%; respectively. 47.6% of patients had reflux during sonde feeding, 14.3% had diarrhea. After 1 week at Intensive Care Unit (ICU), the prevalence of malnutrition (by SGA scale) increased from 35.7% to 78.6%, OR = 2.03, p<0.05, serum protein, albumin, RBC, Hb were markedly decreased (RRR ranged from 6.9% to 10.3%; p<0.05). Factors related to the nutrition status (malnitrition and decrease of some serum indexes) were mostly gastroesophageal reflux  with/without diarrhea which caused increasing rate of malnutriton (OR = 5.2, p<0.05), adversed effect on RBC and serum protein (OR ranged 1.5 - 1.6, p>0.05). 72.9% of infectious patients had CBC < 3×10¹²/l when compared with the rate of 20% in non-infectious patients (OR = 10.8, p<0.05). There was a tendency of increased risk of malnutrition in infectious cases (OR = 2.3, p>0.05). Conclusion: The nutrition status of severe infectious patients worsen during treatment at ICU; the related factors include gastroesophageal reflux and/or diarrhea, infection status during treatment.