• 대한지역사회영양학회지
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• 제24권3호
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• pp.197-207
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• 2019

Objectives: This study examined the characteristics and nutritional risk of the elderly who receive home delivery services. We then analyzed the effects of the characteristics of the elderly who receive the home-delivery meal service on their nutritional risk. Methods: A total of 220 respondents who receive home-delivery meal service in Seoul participated in the survey. The survey consisted of the characteristics of the elderly (health status, tooth condition, physical activity, social participation activity, depression and relationship with neighbors), nutritional risk assessment and other general matters. The data was analyzed by using the SPSS program. Cross-tabulation analysis, t-test, correlation analysis and regression analysis were all conducted. Results: 47.0% of the subjects were under 80 years old and 53.0% were over 80 years old, The nutritional risk score, as evaluated by a Nutrition Screening Initiative (NSI) checklist was 10.7 points, and the high nutrition risk group was 91.5% of the subjects. The subjective self-health status score was 2.24 points (out of a total of 5 points) and the tooth status score was 3.30 points. The physical activity level was 2.17 points for the under 80 years old group and 1.76 points for the over 80 years old, and there was a significant difference according to age (p<0.01), The higher the health status, tooth condition, physical activity and social participation activity level, the lower was the nutritional risk. Further, the higher the degree of depression, the higher was the nutritional risk. Conclusions: For the healthy life of the elderly in the community, various welfare policies should be planned to increase social participation as well as to promote physical health and reduce depression.

• 대한임상독성학회지
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• 제19권2호
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• pp.93-99
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• 2021

Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.

• 지역사회간호학회지
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• 제17권2호
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• pp.186-194
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• 2006

Purpose: This study was to evaluate the nutritional risk and health status of osteoarthritis elderly comparing with that of non-osteoarthritis elderly in urban areas. Methods: A cross-sectional analysis was conducted. The subjects were 132 osteoarthritis elderly, 154 non-osteoarthritis elderly. Data were collected by using a questionnaire including Nutritional Screening Initiatives, blood test and measurement of weight & height. Collected data were analyzed through descriptive statistics and $x^2-test$ by using SPSS 12.0. Results: The percentage of high nutritional risk among osteoarthritis elderly were higher than those among non-osteoarthritis elderly(p<0.01). When comparing the main nutritional risk factors such as 'I eat alone most of the time', 'I don't always have enough money to buy', 'I have tooth or mouth Problems that make it hard for me to eat' between osteoarthritis elderly and non-osteoarthritis elderly, significantly differences were found(p<0.05). There were no statistically significant difference in ADL, BMI, Lymphocyte, Hemoglobin, Hematocrit, Albumin and total-Cholesterol between osteoarthritis elderly and non-osteoarthritis elderly. Conclusion: On the basis of this study, it is necessary to figure out the main factors of nutritional risk in arthritis elderly through the cohort study for effective prevention & control in nutritional risk.

• 한국보건간호학회지
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• 제29권2호
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• pp.312-324
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• 2015

Purpose: This study addressed the relationship among nutritional risk, stress, and health related quality of life for older women with a foreign daughter-in-law. Methods: A descriptive research design was used for this study. The subjects of this study were 112 older women with a foreign daughter-in-law all of whom were over 65 years and living in D city. Personal interview was used for data collection. Nutritional risk, stress, and health related quality of life were measured using Nutrition Screening Initiative (NSI), Family Inventor of Life Events and Changes (FILE), and Medical Outcome Study (MOS) Short-form 36-Item Health Survey (SF-36), respectively. Results: Older women with a foreign daughter-in-law showed negative correlation between quality of life related health and nutritional risk, stress and age, and positive correlation between Activities of Daily Living (ADL); 46% of variance in health related quality of life of older women with a foreign daughter-in-law was explained by nutritional risk, ADL, stress and occupation. Conclusion: Based on the results of this study, we suggested that specialized programs should be established to help in development of social relationship networks for older women who have a foreign daughter-in-law.

• Journal of Nutrition and Health
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• 제42권2호
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• pp.119-127
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• 2009

이 연구는 다양한 병명을 가진 입원환자의 영양불량위험의 진단을 간단하고 신속하게 실시할 수 있고 재원기간 내의 임상결과를 유의하게 예측하며 NRS 2002와 비교하여 평가하였을 때 일정 수준 이상의 타당도를 가지는 영양불량 위험 검색도구를 (Nutritional Risk Screening Tool, NRST) 개발하고자 하였다. NRST의 개발 및 평가는 서울 소재 일개 종합병원에 1년여의 기간 동안 입원한 성인 환자를 대상으로 수집된 자료를 이용하여 NRST 구성요소의 선정, NRST scoring scheme의 탐색, NRST 평가의 기준점 설정, NRST의 임상결과 예측력 재확인 등의 총 4단계의 과정을 통하여 실시되었다. 아래에 본 연구의 결과 및 결론을 요약하였다. 1) 재원일수, 사망여부, 합병증 유무, 질병예후를 각각 종속변수로 하는 stepwise multiple regression을 시행한 결과 나이와 혈청 내 albumin, TLC, Hct 농도가 NRST의 구성요소로 선정되었다. 2) 선정된 각 NRST 구성요소의 수준에 따른 NRS 2002의 OR에 기준하여 NRST의 scoring scheme을 아래와 같이 설정하였다. $NRST=Albumin{\times}1+Age{\times}2.5+Hct{\times}1.5+TLC{\times}2{\ast}$ ${\ast}$ Coding:Albumin <3.5:1, ${\geqq}$ 3.5：0.Age>65:1, ${\leqq}$65:0.Hct<37:1, ${\geqq}$37：0.TLC<1800：1, ${\geqq}$1800：0. 3) NRST의 점수변화에 따른 NRS 2000에 대한 민감도와 특이도를 바탕으로 NRST에 의한 영양불량 위험의 진단 기준점수를 3.5 이상으로 정하였다. 4) NRST 결과에 따른 재원일수, 합병증여부, 질병 예후, 사망여부 등의 차이를 검토한 결과 개발된 NRST가 만족할 만한 수준의 임상결과 예측력을 가지는 것으로 나타났다. 5) NRST는 다양한 진단명을 가진 입원환자의 영양불량 위험 여부를 향후의 임상결과와 관련하여 신속하게 진단하는데 유용하리라 사료된다.

• 대한지역사회영양학회지
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• 제13권4호
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• pp.573-581
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• 2008

Although it is well known that cancer patients suffer from malnutrition, there are few published studies on malnutrition in outpatients receiving chemotherapy in Korea. This study aimed to evaluate nutritional risk in oncology outpatients receiving chemotherapy and to show the baseline data to set up nutritional management programs for cancer patients. This is a retrospective observational analysis on 1,962 patients referred for nutritional education before or during chemotherapy at Seoul National University Hospital Cancer Center from January 2006 to May 2007. According to a malnutrition screening tool, the proportion of patients having malnutrition risk was 23.0%. In the case of upper gastrointestinal cancer, more than 50% of patients were assessed as being at the risk of malnutrition. They showed more than 7% weight loss compared to their usual body weight and poor oral intake; energy intake was less than 100% of Basal Energy Expenditure(BEE) and protein intake was less than or equal to 0.77 g/kg/d. However, only 6.3% of breast cancer patients had risk of malnutrition and their oral intake was better; energy intake was 121% of BEE, and protein intake was 0.90 g/kg/d. Outpatients receiving chemotherapy had different nutritional risk depending on their cancer site. Nutritional management program should be conducted differently, depending on the cancer site and upper gastrointestinal cancer patients at high risk of malnutrition should basically have nutritional assessment and intervention.

• 대한영양사협회학술지
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• 제16권2호
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• pp.122-132
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• 2010

Elderly people comprise an increasing proportion of the population, and nutritional impairments may contribute to health problems among this group. This study was conducted to evaluate the nutritional status by Mini-Nutritional Assessment (MNA) and to identify relationships among anthropometric measurements, biochemical indicators, bone Mineral Density (BMD) and MNA results among older adults (${\geq}$65 yrs, n=98, 66.7${\pm}$2.5 yrs; M=52, F=46, BMI 24.5${\pm}$2.8 $kg/m^2$) at a Health Care Center. A dietitian administered MNA and collected anthropometric measurements (weight, height, waist circumference), biochemical indicators (albumin, hemoglobin, hematocrit, TLC, glucose, lipids) and the BMD (spine, femur, F=46). Subjects were grouped into a normal nutrition group (0~2 risk factors of malnutrition) and a high risk of malnutrition group (>=3 risk factors of malnutrition) based on their risk factor status for malnutrition. The risk factors for malnutrition include age ${\geq}$65 years, PIBW <90%, albumin <3.5 g/dl, TLC <1,500%, Hgb <14 g/dl (men), Hgb <10 g/dl (women), loss of appetite and weight loss 1~3 kg/last 3 months. In addition, subjects were grouped into a normal, osteopenia and osteoporosis group by BMD. We found that 12% of the subjects were at risk of malnutrition (MNA score, 21.4${\pm}$2.1) and that 88% were well nourished (27.3${\pm}$1.5) according to the MNA. Full-MNA scores were positively and significantly (p<0.05) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), albumin and hemoglobin, respectively. The full-MNA score of the high risk of malnutrition group (23.0${\pm}$3.8) was lower than that of the normal nutrition group (27.0${\pm}$2.1) (p<0.05). In addition, the Full-MNA score was negatively associated with the risk factor of malnutrition (r=－0.35, p=0.0004). We found that 39.1% of the subjects had osteoporosis, 45.7% had osteopenia and 15.2% were normal according to their BMD. The MNA score of osteoporosis group (24.58${\pm}$3.3) was lower than that of the normal (27.4${\pm}$1.1) and osteopenia group (26.9${\pm}$1.5) (p<0.05). These results suggested that MNA can be useful as a nutritional screening tool of older adults in Health Care Centers.

• Nutrition Research and Practice
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• 제15권4호
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• pp.504-515
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• 2021

BACKGROUND/OBJECTIVES: Malnutrition risk and malnutrition among the elderly is a public health concern. In combating this health-related problem, it is critically important to evaluate the risk factors in a multidimensional way and to apply appropriate nutrition intervention based on the results. SUBJECTS/METHODS: A cross-sectional study was conducted on 215 elderly patients (32.6% male, 67.4% female) in a geriatric outpatient clinic of a hospital in Turkey. Nutritional questionnaires that incorporated the 24-h recall method were applied to determine general characteristics of patients, their health status, nutritional habits, and daily energy and nutrient intakes. Mini Nutritional Assessment was used to determine nutritional status. Relevant anthropometric measurements were obtained. RESULTS: The subjects' mean age was 76.1 ± 7.0 years, and the prevalence of malnutrition (n = 7) and risk of malnutrition (n = 53) among the 215 subjects was 3.2% and 24.7%, respectively. Patients with malnutrition or risk of malnutrition were found to be single, have a depression diagnosis, in an older age group, have less appetite, more tooth loss, have more frequent swallowing/chewing difficulty, and have more frequent meal skipping. In addition, mean daily energy, carbohydrate, fat, fiber, vitamin E, vitamin B1, vitamin B2, vitamin B6, vitamin C, folates, potassium, magnesium, phosphorus, iron intake, and water consumption were found to be statistically significantly low in subjects with malnutrition or risk of malnutrition. After performing regression analysis to determine confounding factors, malnutrition risk was significantly associated with marital status, loss of teeth, appetite status, and depression. CONCLUSIONS: Routine nutritional screening and assessment of the elderly should be performed. If nutritional deficiencies cannot be diagnosed early and treated, self-sufficiency in the elderly may deteriorate, resulting in increased institutionalization.

• 대한지역사회영양학회지
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• 제26권4호
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• pp.280-295
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• 2021

Objectives: This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Journal of Nutrition and Health
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• 제43권2호
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• pp.189-196
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• 2010

입원환자의 초기 영양관리를 위해 개발한 영양검색 도구의 타당성을 평가 하고자 입원 후 48시간 이내에 동일한 대상자에게 KNNRS, PG-SGA, NRS-2002를 수행하였으며 그 결과를 비교 평가하였다. 1) KNNRS, PG-SGA, NRS-2002를 이용한 영양검색결과 영양상태 불량 및 영양불량 위험도가 높은 환자의 비율은 각각 28.7%, 51.3%, 48.5%로 나타났다. 2) 각 영양검색 도구에 따라 영양상태 불량 및 영양불량 위험도가 높은 것으로 나타난 환자는 영양상태 양호 및 영양불량 위험도가 낮은 환자에 비해 공통적으로 평균연령이 높고 BMI, 혈중 헤모글로빈, 총 임파구수, 알부민 수치가 유의적으로 낮았다. 3) KNNRS와 PG-SGA에 의한 영양상태 분류를 비교하였을 때 KNNRS에서 영양상태가 양호한 환자 545명 중 PG-SGA에 의해 영양상태가 양호한 환자는 331명이었다. KNNRS에서 영양상태가 불량한 환자 219명 중 PG-SGA에서도 영양상태가 불량한 환자는 178명이었다. 민감도와 특이도는 각각 60.7% (95%CI 54.2-67.0), 81.2% (95% CI 75.3-85.2)로 영양불량 상태를 판정하는데 두 도구가 임상적 관련성이 있는 것으로 사료된다. 두 도구 간 유사성 kappa 지수는 0.34로 KNNRS는 PG-SGA를 기준으로 타당한 검색도구로 검증되었다. 4) KNNRS와 NRS-2002에 의한 영양상태 분류를 비교하였을 때 KNNRS에서 영양상태가 양호한 환자 540명 중 NRS-2002에 의해 영양불량 위험도가 낮은 환자는 312명 이었다. KNNRS에서 영양상태가 불량한 환자 216명 중 NRS-2002에서 영양불량 위험도가 높은 환자는 139명이었다. 민감도와 특이도는 각각 57.8% (95%CI 53.4-60.9), 64.4% (95%CI 60.2-69.8)로 영양불량 상태를 판정하는 데 두 도구가 임상적 관련성이 적은 것으로 사료된다. 두 도구 간 유사성은 kappa 지수 0.18로 낮게 나타났다. 5) KNNRS가 PG-SGA 결과와 비교 시 타당성이 검증되었으나 영양불량환자의 비율은 28.7%로 PG-SGA와 NRS-2002의 51.3%, 48.5%에 비해 낮았다. 보다 효과적이고 적극적인 초기 영양관리 중재를 위하여 영양불량 판정 기준의 수정 보완이 필요하다. 6) 영양검색 도구의 유효성과 영양관리의 효과를 검증하기 위하여 재원일수, 합병증 여부, 질병 예후, 사망여부와의 연계연구가 필요하다.