Correlations between admission nutritional markers and pressure injury in elderly patients with chronic obstructive pulmonary disease_West China Medical Journal

Authors：

YANG Tao ^1,2 ,  HU Wen ^1,3 , CHENG Yi ³ , GONG Jie ³

1. West China School of Public Health / West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Geriatrics, Dujiangyan People’s Hospital, Dujiangyan, Sichuan 611830, P. R. China;
3. Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HU Wen, Email: wendy_nutrition@163.com

Keywords：

Pressure injury; chronic obstructive pulmonary disease; elderly patient; nutritional markers; early warning

DOI：

10.7507/1002-0179.202207171

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the correlations between nutritional markers and pressure injury (PI) in elderly patients with chronic obstructive pulmonary disease (COPD). Methods Retrospective analysis was conducted on elderly patients with COPD and PI who were admitted to the geriatric department of West China Hospital of Sichuan University or Dujiangyan People’s Hospital between January 2020 and December 2021. The blood biochemical indicators mainly including nutritional markers were collected, and their correlations with PI risk factor index Braden score and PI severity index PI stage were analyzed. Results A total of 293 patients with COPD and PI were included. Among the five Braden score groups, the differences in the levels of albumin and prealbumin were statistically significant (P<0.05), and the Braden score was positively correlated with albumin (r_s=0.241, P<0.001), prealbumin (r_s=0.179, P=0.002), and hemoglobin (r_s=0.199, P=0.001). Among the six PI stage groups, the differences in the levels of albumin, globulin, red blood cell count, serum sodium, blood chloride and C-reactive protein were statistically significant (P<0.05), and the PI stage was negatively correlated with albumin (r_s=?0.192, P=0.001), and positively correlated with serum sodium (r_s=0.139, P<0.001), blood chloride (r_s=0.184, P<0.001), and C-reactive protein (r_s=0.177, P=0.020). Conclusion When PI risk assessment and severity assessment are performed on elderly COPD patients, it is necessary to pay more attention to nutritional markers and assess whether the patients are at risk of protein malnutrition, which will help to improve the accuracy of PI risk assessment and severity prediction, and effectively improve the efficacy of PI prevention and treatment.

Citation： YANG Tao, HU Wen, CHENG Yi, GONG Jie. Correlations between admission nutritional markers and pressure injury in elderly patients with chronic obstructive pulmonary disease. West China Medical Journal, 2023, 38(1): 28-33. doi: 10.7507/1002-0179.202207171 Copy

1.	Donini LM, De Felice MR, Tagliaccica A, et al. Nutritional status and evolution of pressure sores in geriatric patients. J Nutr Health Aging, 2005, 9(6): 446-454.
2.	Bonnefoy M, Coulon L, Bienvenu J, et al. Implication of cytokines in the aggravation of malnutrition and hypercatabolism in elderly patients with severe pressure sores. Age Ageing, 1995, 24(1): 37-42.
3.	Casimiro C, García-de-Lorenzo A, Usán L. Prevalence of decubitus ulcer and associated risk factors in an institutionalized Spanish elderly population. Nutrition, 2002, 18(5): 408-414.
4.	Zhang Z, Pereira SL, Luo M, et al. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: a systematic review and meta-analysis. Nutrients, 2017, 9(8): 829.
5.	朱勝春. 壓瘡高危患者臨床特征及危險因素分析. 護理學報, 2010, 17(5): 72-74.
6.	劉又寧. 實用臨床呼吸病學. 北京: 科學技術文獻出版社, 2007: 313.
7.	Cox J, Rasmussen L. Enteral nutrition in the prevention and treatment of pressure ulcers in adult critical care patients. Crit Care Nurse, 2014, 34(6): 15-27.
8.	中華醫學會呼吸病學分會慢性阻塞性肺疾病學組. 慢性阻塞性肺疾病診治指南(2013 年修訂版)(一). 全科醫學臨床與教育, 2013(5): 484-491.
9.	European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries: clinical practice guideline. The international guideline, 3rd edition. EPUAP/NPIAP/PPPIA, 2019. http://www.internationalguideline.com.
10.	Barczak CA, Barnett RI, Childs EJ, et al. Fourth national pressure ulcer prevalence survey. Adv Wound Care, 1997, 10(4): 18-26.
11.	Cabrerizo S, Cuadras D, Gomez-Busto F, et al. Serum albumin and health in older people: review and meta analysis. Maturitas, 2015, 81(1): 17-27.
12.	王春生, 時志斌, 劉安慶, 等. 脊髓損傷截癱患者血白蛋白變化與壓瘡的關系. 中國臨床康復, 2004, 8(8): 1422-1423.
13.	Hickson M. Malnutrition and ageing. Postgrad Med J, 2006, 82(963): 2-8.
14.	瑪麗·寬德, 托尼亞·萊因哈德. 臨床營養指導手冊. 2 版. 周蕓, 樊輝, 譯. 北京: 人民衛生出版社, 2019: 21.
15.	Aguayo-Becerra OA, Torres-Garibay C, Macías-Amezcua MD, et al. Serum albumin level as a risk factor for mortality in burn patients. Clinics (Sao Paulo), 2013, 68(7): 940-945.
16.	Lin MY, Liu WY, Tolan AM, et al. Preoperative serum albumin but not prealbumin is an excellent predictor of postoperative complications and mortality in patients with gastrointestinal cancer. Am Surg, 2011, 77(10): 1286-1289.
17.	鄭碧霞, 彭雅君, 任宇俊. 院外帶入壓瘡相關因素分析及預防. 齊齊哈爾醫學院學報, 2008, 29(12): 1427-1429.
18.	中國老年醫學學會營養與食品安全分會, 中國循證醫學中心, 《中國循證醫學雜志》編輯委員會, 等. 老年患者家庭營養管理中國專家共識(2017 版). 中國循證醫學雜志, 2017, 17(11): 1251-1259.
19.	馬方清, 李湘波. Ⅱ、Ⅲ度營養不良合并電解質紊亂 42 例的診療體會. 中國醫師雜志, 2003(6): 787.
20.	張靜, 王衍富. 慢性阻塞性肺疾病患者能量代謝與營養不良研究進展. 醫學與哲學, 2016, 37(2): 58-61.
21.	Litchford MD. Putting the 2019 nutrition recommendations for pressure injury prevention and treatment into practice. Adv Skin Wound Care, 2020, 33(9): 462-468.
22.	Bourdel-Marchasson I, Barateau M, Rondeau V, et al. A multi-center trial of the effects of oral nutritional supplementation in critically ill older inpatients. GAGE Group. Groupe Aquitain Geriatrique d’Evaluation. Nutrition, 2000, 16(1): 1-5.
23.	Roberts S, Chaboyer W, Leveritt M, et al. Nutritional intakes of patients at risk of pressure ulcers in the clinical setting. Nutrition, 2014, 30(7/8): 841-846.
24.	Amano K, Morita T, Baba M, et al. Effect of nutritional support on terminally ill patients with cancer in a palliative care unit. Am J Hosp Palliat Care, 2013, 30(7): 730-733.
25.	Banks MD, Graves N, Bauer JD, et al. Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals. Eur J Clin Nutr, 2013, 67(1): 42-46.
26.	Tuffaha HW, Roberts S, Chaboyer W, et al. Cost-effectiveness and value of information analysis of nutritional support for preventing pressure ulcers in high-risk patients: implement now, research later. Appl Health Econ Health Policy, 2015, 13(2): 167-179.
27.	Tuffaha HW, Roberts S, Chaboyer W, et al. Cost-effectiveness analysis of nutritional support for the prevention of pressure ulcers in high-risk hospitalized patients. Adv Skin Wound Care, 2016, 29(6): 261-267.

1. Donini LM, De Felice MR, Tagliaccica A, et al. Nutritional status and evolution of pressure sores in geriatric patients. J Nutr Health Aging, 2005, 9(6): 446-454.
2. Bonnefoy M, Coulon L, Bienvenu J, et al. Implication of cytokines in the aggravation of malnutrition and hypercatabolism in elderly patients with severe pressure sores. Age Ageing, 1995, 24(1): 37-42.
3. Casimiro C, García-de-Lorenzo A, Usán L. Prevalence of decubitus ulcer and associated risk factors in an institutionalized Spanish elderly population. Nutrition, 2002, 18(5): 408-414.
4. Zhang Z, Pereira SL, Luo M, et al. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: a systematic review and meta-analysis. Nutrients, 2017, 9(8): 829.
5. 朱勝春. 壓瘡高危患者臨床特征及危險因素分析. 護理學報, 2010, 17(5): 72-74.
6. 劉又寧. 實用臨床呼吸病學. 北京: 科學技術文獻出版社, 2007: 313.
7. Cox J, Rasmussen L. Enteral nutrition in the prevention and treatment of pressure ulcers in adult critical care patients. Crit Care Nurse, 2014, 34(6): 15-27.
8. 中華醫學會呼吸病學分會慢性阻塞性肺疾病學組. 慢性阻塞性肺疾病診治指南(2013 年修訂版)(一). 全科醫學臨床與教育, 2013(5): 484-491.
9. European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries: clinical practice guideline. The international guideline, 3rd edition. EPUAP/NPIAP/PPPIA, 2019. http://www.internationalguideline.com.
10. Barczak CA, Barnett RI, Childs EJ, et al. Fourth national pressure ulcer prevalence survey. Adv Wound Care, 1997, 10(4): 18-26.
11. Cabrerizo S, Cuadras D, Gomez-Busto F, et al. Serum albumin and health in older people: review and meta analysis. Maturitas, 2015, 81(1): 17-27.
12. 王春生, 時志斌, 劉安慶, 等. 脊髓損傷截癱患者血白蛋白變化與壓瘡的關系. 中國臨床康復, 2004, 8(8): 1422-1423.
13. Hickson M. Malnutrition and ageing. Postgrad Med J, 2006, 82(963): 2-8.
14. 瑪麗·寬德, 托尼亞·萊因哈德. 臨床營養指導手冊. 2 版. 周蕓, 樊輝, 譯. 北京: 人民衛生出版社, 2019: 21.
15. Aguayo-Becerra OA, Torres-Garibay C, Macías-Amezcua MD, et al. Serum albumin level as a risk factor for mortality in burn patients. Clinics (Sao Paulo), 2013, 68(7): 940-945.
16. Lin MY, Liu WY, Tolan AM, et al. Preoperative serum albumin but not prealbumin is an excellent predictor of postoperative complications and mortality in patients with gastrointestinal cancer. Am Surg, 2011, 77(10): 1286-1289.
17. 鄭碧霞, 彭雅君, 任宇俊. 院外帶入壓瘡相關因素分析及預防. 齊齊哈爾醫學院學報, 2008, 29(12): 1427-1429.
18. 中國老年醫學學會營養與食品安全分會, 中國循證醫學中心, 《中國循證醫學雜志》編輯委員會, 等. 老年患者家庭營養管理中國專家共識(2017 版). 中國循證醫學雜志, 2017, 17(11): 1251-1259.
19. 馬方清, 李湘波. Ⅱ、Ⅲ度營養不良合并電解質紊亂 42 例的診療體會. 中國醫師雜志, 2003(6): 787.
20. 張靜, 王衍富. 慢性阻塞性肺疾病患者能量代謝與營養不良研究進展. 醫學與哲學, 2016, 37(2): 58-61.
21. Litchford MD. Putting the 2019 nutrition recommendations for pressure injury prevention and treatment into practice. Adv Skin Wound Care, 2020, 33(9): 462-468.
22. Bourdel-Marchasson I, Barateau M, Rondeau V, et al. A multi-center trial of the effects of oral nutritional supplementation in critically ill older inpatients. GAGE Group. Groupe Aquitain Geriatrique d’Evaluation. Nutrition, 2000, 16(1): 1-5.
23. Roberts S, Chaboyer W, Leveritt M, et al. Nutritional intakes of patients at risk of pressure ulcers in the clinical setting. Nutrition, 2014, 30(7/8): 841-846.
24. Amano K, Morita T, Baba M, et al. Effect of nutritional support on terminally ill patients with cancer in a palliative care unit. Am J Hosp Palliat Care, 2013, 30(7): 730-733.
25. Banks MD, Graves N, Bauer JD, et al. Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals. Eur J Clin Nutr, 2013, 67(1): 42-46.
26. Tuffaha HW, Roberts S, Chaboyer W, et al. Cost-effectiveness and value of information analysis of nutritional support for preventing pressure ulcers in high-risk patients: implement now, research later. Appl Health Econ Health Policy, 2015, 13(2): 167-179.
27. Tuffaha HW, Roberts S, Chaboyer W, et al. Cost-effectiveness analysis of nutritional support for the prevention of pressure ulcers in high-risk hospitalized patients. Adv Skin Wound Care, 2016, 29(6): 261-267.

West China Medical Journal

Correlations between admission nutritional markers and pressure injury in elderly patients with chronic obstructive pulmonary disease

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content