REHABILITACIJA PODHRANJENEGA PACIENTA - KJE SMO IN KAM NAPREJ? (Slovenian)

Background: In recent years, attention has increasingly been paid to nutritional treatment as part of the rehabilitation program. Many factors can influence nutritional and metabolic status, the most common of which are long-term inactivity, poor appetite, increased energy and nutritional needs when participating in therapies, occasionally swallowing disorders and chronic systemic diseases. With optimal nutritional support, we can enable the patient to progress and heal faster and reduce the incidence of complications. Methods: Fifty-seven patients who were hospitalized on November 10, 2022, in one of the hospital wards of the University Rehabilitation Institute of Republic of Slovenia (URI) were included in the empirical prospective research, which took place as part of the NutritionDay project. In the analysis, we included data obtained with the nutritional anamnesis and status, the NRS-2002 screening tool, and body composition measurements. Results: According to the GLIM criteria, 51 (90 %) of the included patients were malnourished, of whom 22 (39 %) were severely malnourished. Twenty-two (39 %) patients met the criteria for sarcopenia. In the group of patients who lost part of their body mass in the last six months, the average loss was 15 % (SD 7 %), and in the group who started losing body mass more than 6 months before admission, the average loss was 23 % (SD 9 %). Within the analysis of body composition parameters, total body water was increased in 11 patients (20 %), and the fat-free mass index (FFMI) was decreased in 20 (35 %). Only two patients had a phase angle above the fifth population percentile (according to age and sex). Conclusion: The results of the research show that the proportion of nutritionally compromised and malnourished patients in the rehabilitation environment is high, so active screening is essential. The goals for the future are aimed primarily at raising awareness about the importance and recognition of nutrition disorders among physical and rehabilitation medicine specialists, and involving dietitians at the primary and secondary levels of health care. [ABSTRACT FROM AUTHOR]

Izhodišča: Prehranski obravnavi se znotraj rehabilitacije v zadnjih letih posveča vedno več pozornosti. Paciente prehransko in presnovno ogroža veliko različnih dejavnikov, med katerimi so najpogostejši dolgotrajna neaktivnost, slab apetit, povečane energijsko hranilne potrebe ob vključevanju v terapije, občasno tudi motnje požiranja in pridružena kronična sistemska obolenja. Z optimalno prehransko podporo lahko pacientu omogočimo hitrejši napredek in celjenje ter zmanjšamo pojavnost zapletov. Metode: V empirično prospektivno raziskavo, ki je potekala v sklopu projekta NutritionDay, je bilo vključenih 57 pacientov, ki so bili 10. novembra 2022 hospitalizirani na enem od bolnišničnih oddelkov Univerzitetnega rehabilitacijskega inštituta Soča (URI Soča). V analizo smo vključili podatke, pridobljene s pomočjo prehranske anamneze in statusa, presejalnega orodja NRS-2002 in meritve telesne sestave. Rezultati: Glede na merila GLIM je bilo 51 (90 %) vključenih pacientov podhranjenih, od tega 22 (39 %) hudo podhranjenih. Merila za sarkopenijo je doseglo 22 (39 %) pacientov. V skupini pacientov, ki so del telesne mase izgubili v zadnjih šestih mesecih, je bila povprečna izguba 15 % (SD 7 %). V skupini pacientov, ki so telesno maso začeli izgubljati več kot 6 mesecev pred sprejemom, pa je bila povprečna izguba 23 % (SD 9 %). Pri analizi parametrov telesne sestave je bila pri 11 pacientih (20 %) povišana celokupna telesna voda, pri 20 (35 %) je bil znižan indeks nemaščobne mase (FFMI). Le dva pacienta sta imela fazni kot nad petim populacijskim percentilom (glede na starost in spol). Zaključek: Rezultati raziskave kažejo, da je delež prehransko ogroženih in podhranjenih pacientov v rehabilitacijskem okolju visok, zato je aktivno iskanje teh pacientov nujno. Cilji za prihodnost so usmerjeni predvsem v osveščanje specialistov fizikalne in rehabilitacijske medicine o pomenu in prepoznavanju motenj prehranjenosti ter vključevanje dietetikov na primarno in sekundarno raven zdravstvene oskrbe. [ABSTRACT FROM AUTHOR]

Copyright of Rehabilitation / Rehabilitacija is the property of University Rehabilitation Institute, Republic of Slovenia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)