Investigation and analysis of nutritional status and its influencing factors of adult inpatients with tuberculosis in Wenzhou City

doi:10.19982/j.issn.1000-6621.20230292

Abstract

Abstract:

Objective: To analyze the nutritional status and risk factors of adult tuberculosis inpatients in Wenzhou City, so as to provide reference for early nutritional intervention. Methods: A total of 740 patients with tuberculosis diagnosed in the Infection Department of Wenzhou Central Hospital from January 1 to July 5, 2023 were selected. Excluding 4 patients who could not get measured for weight due to usage of trolley or wheelchair, 2 patients with severe mental illness and 18 patients with incomplete laboratory data, 716 patients were included in the study. Demographic, clinical and laboratory data on admission were collected, including sex, age, diagnostic type of tuberculosis, type of treatment, complication, BMI, number of affected lung fields, detection of Mycobacterium Tuberculosis, drug resistance, nutritional risk screening-2002 (NRS-2002) results, serum total protein, albumin, prealbumin, hemoglobin, lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), prognostic nutrition index (PNI), etc. The above data were statistically compared, and the occurrence and influencing factors of nutritional risk were analyzed. Results: Among the 716 patients, 231 patients with NRS 2002 score ≥3 were included in the nutritional risk group, and 485 patients with NRS 2002 score <3 were included in the non-nutritional risk group. The incidence of nutritional risk was 32.26% (231/716). Multivariate logistic regression analysis showed the affected lung fields >3 (OR (95%CI)=2.066 (1.349-3.165)), albumin <30 g/L (OR (95%CI)=4.468 (1.767-11.297)), prealbumin ≤200 g/L (100-200 g/L: OR (95%CI)=2.249 (1.377-3.674), <100 g/L: OR (95%CI)=5.585 (2.841-10.981)), hemoglobin ≤120 g/L (91-119 g/L: OR (95%CI)=2.205 (1.458-3.335), ≤90 g/L: OR (95%CI)=2.882 (1.374-6.047)) were risk factors of nutritional risk in patients. Conclusion: The incidence of nutritional risk of adult inpatients with tuberculosis in Wenzhou City is high. In the course of treatment, more attention should be paid to the nutritional status of these patients, especially those with affected lung fields >3, low albumin/prealbumin/hemoglobin.

Key words: Tuberculosis, Nutritional status, Risk factors

CLC Number:

R52
R151

Wu Lianpeng, Xia Dandan, Xu Ke. Investigation and analysis of nutritional status and its influencing factors of adult inpatients with tuberculosis in Wenzhou City[J]. Chinese Journal of Antituberculosis, 2024, 46(1): 100-105. doi: 10.19982/j.issn.1000-6621.20230292

Figures/Tables 4

临床指标	β值	s $x ˉ$ 值	Wald χ²值	P值	OR值	95%CI值
病变肺野数≥3个	0.726	0.218	11.125	0.001	2.066	1.349~3.165
白蛋白(以>40g/L为参照)
30~40g/L	0.377	0.433	0.755	0.385	1.457	0.623~3.408
<30g/L	1.497	0.473	10.005	0.002	4.468	1.767~11.297
前白蛋白(以>200g/L为参照)
100~200g/L	0.810	0.250	10.480	0.001	2.249	1.377~3.674
<100g/L	1.720	0.345	24.869	<0.001	5.585	2.841~10.981
血红蛋白(以≥120g/L为参照)
91~119g/L	0.791	0.211	14.030	<0.001	2.205	1.458~3.335
≤90g/L	1.058	0.378	7.837	0.005	2.882	1.374~6.047

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NRS 2002评分得分	例数	构成比(%)
0	231	32.26
1	189	26.40
2	65	9.08
3	136	18.99
4	67	9.36
5	16	2.23
6	12	1.68

因素	营养风险组(231例)		无营养风险组(485例)		χ²值	P值
因素	例数	构成比(%)	例数	构成比(%)	χ²值	P值
性别					1.330	0.249
男性	165	71.43	366	75.46
女性	66	28.57	119	24.54
年龄(岁)					32.386	<0.001
18~40	56	24.24	110	22.68
41~60	58	25.11	202	41.65
61~80	87	37.66	154	31.75
81~95	30	12.99	19	3.92
BMI					397.827	<0.001
<18.50	152	65.80	3	0.62
18.50~23.99	73	31.60	367	75.67
≥24.00	6	2.60	115	23.71
结核病类型					10.263	0.006
肺结核	208	90.04	444	91.55
肺外结核	6	2.60	27	5.57
肺结核合并肺外结核	17	7.36	14	2.88
治疗类型					2.456	0.117
初治	207	89.61	414	85.36
复治	24	10.39	71	14.64
合并症					9.614	0.002
有	188	81.39	342	70.52
无	43	18.61	143	29.48
病变肺野数(个)					31.501	<0.001
<3	44	19.05	195	40.21
≥3	187	80.95	290	59.79
结核分枝杆菌检出情况					3.302	0.069
菌阳	204	88.31	403	83.09
菌阴	27	11.69	82	16.91
结核分枝杆菌耐药情况					0.390	0.532
耐药	28	12.12	67	13.81
敏感	203	87.88	418	86.19
TP(g/L)					48.909	<0.001
<65	142	61.47	164	33.81
≥65	89	38.53	321	66.19
ALB(g/L)					154.627	<0.001
<30	130	56.28	62	12.78
30~40	94	40.69	356	73.40
>40	7	3.03	67	13.82
PAB(mg/L)					131.954	<0.001
<100	77	33.33	28	5.77
100~200	126	54.55	237	48.87
>200	28	12.12	220	45.36
Hb(g/L)					102.636	<0.001
≤90	35	15.15	18	3.71
91~119	126	54.55	131	27.01
≥120	70	30.30	336	69.28
LYM(×10⁹/L)					41.322	<0.001
<1.1	132	57.14	155	31.96
≥1.1	99	42.86	330	68.04
NLR					45.800	<0.001
<4	83	35.93	305	62.89
≥4	148	64.07	180	37.11
PNI					103.726	<0.001
<40	176	76.19	176	36.29
40~45	39	16.88	160	32.99
>45	16	6.93	149	30.72

变量	赋值	变量	赋值
是否存在营养风险	否=0;是=1	白蛋白(g/L)	>40=0;30~40=1;<30=2
是否存在营养风险	否=0;是=1	前白蛋白(g/L)	>200=0;100~200=1;<100=2
结核病类型	单纯肺结核=0;肺外结核=1;肺结核合并肺外结核=2	前白蛋白(g/L)	>200=0;100~200=1;<100=2
结核病类型	单纯肺结核=0;肺外结核=1;肺结核合并肺外结核=2	血红蛋白(g/L)	≥120=0;91~119=1;≤90=2
合并症	无=0;有=1	血红蛋白(g/L)	≥120=0;91~119=1;≤90=2
合并症	无=0;有=1	淋巴细胞计数(×10⁹/L)	≥1.1=0;<1.1=1
病变肺野数	病变肺野数<3个=0;病变肺野数≥3个=1	淋巴细胞计数(×10⁹/L)	≥1.1=0;<1.1=1
病变肺野数	病变肺野数<3个=0;病变肺野数≥3个=1	NLR	<4=0;≥4=1
总蛋白(g/L)	≥65=0;<65=1	NLR	<4=0;≥4=1
总蛋白(g/L)	≥65=0;<65=1	PNI	>45=0;40~45=1;<40=2