Hale TURHAN DAMAR, Özlem BİLİK, Ayşegül SAVCI

Ortopedi Hastalarının Malnütrisyon Durumları ve Risk Faktörlerinin Belirlenmesi

Giriş ve Amaç: Bu çalışmanın amacı ortopedi hastalarının malnütrisyon durumlarının ve risk faktörlerinin belirlenmesidir. Gereç ve Yöntemler: Kesitsel tipteki çalışma 05/2017 -12/2018 tarihleri arasında XXX hastanesinde Ortopedi ve Travmatoloji Kliniğinde toplam 123 hasta ile gerçekleştirildi. Araştırma verileri, Hasta Tanılama ve Klinik Formu, Nutrisyonel Risk Taraması Ölçeği (Nutritional Risk Screening) kullanılarak toplanmıştır. Bulgular: Hastaların yaş ortalaması 65,72±20,79 dır. Cerrahi girişim geçiren hastaların aç kalma süre ortalamaları ameliyat öncesi 10,82±3,20 saat, ameliyat sonrası ise 11,01±10,84 saattir. Hastaların %31,7’sinin malnütriyon riski altında olduğu ve tamamının beslenme desteği almadığı saptandı. Malnütrisyon riski olan hastaların yaş ortalaması daha yüksekti (t=-4,087, p=0,000). Malnütriyon riski olan hastaların ameliyat öncesi aç kalma süreleri, riski olmayanlara göre daha uzundu (t=-3,019, p=0,000). Ameliyat olup malnütrisyon riski olan hastaların ameliyat sonrası ilk mobilizasyonları daha uzun sürede gerçekleşmişti (t=-4,113, p=0,000). Hastaların albumin değerleri ile NRS skorları arasında istatiksel olarak anlamlı bir fark saptandı (t=5,751, p=0,000). Katılımcıların cinsiyet (X2=4,809 p=0,028), eğitim düzeyleri (X2=10,358, p=0,0016), kronik hastalık varlığı (X2=5,890, p=0,015) ve enfeksiyonu durumu (X2=7,566, p=0,006) ile NRS skorları arasında istatiksel olarak anlamlı fark saptandı. Sonuç: Çalışmamızda yaklaşık üç hastadan birinin malnütriyon riski altında olduğu saptanmıştır. Araştırma sonuçları hastaların malnütrisyon riskini etkileyen diğer seçilmiş faktörlerin yaş, cinsiyet, hastaların eğitim düzeyi, komorbit hastalık varlığı, düşük albumin düzeyi, ameliyat öncesi açlık süresi ve ameliyat sonrası enfeksiyon gelişmesi olduğunu göstermiştir. Ayrıca malnütrisyon riski olan hastaların ameliyat sonrası ilk mobilizasyon sürelerinin daha geç olduğu saptanmıştır. Güncel rehberler doğrultusunda, profesyonel bir ekip yaklaşımı ile beslenme desteği yaklaşımları standart haline getirilmelidir.

Anahtar Kelimeler:

beslenme, beslenme risk değerlendirme, ortopedi ve travmatoloji

Determination of Malnutrition Status and Risk Factors in Orthopedic Patients

Objective: The aim of this study is to determine the malnutrition status and risk factors in orthopedic patients. Materials and Methods: The cross-sectional study was conducted between 05/2017 and 12/2018 in a university hospital in the west of Turkey Orthopedics and Traumatology Clinic with 123 patients. Research data were collected using the Patient Diagnosis and Clinical Form, Nutritional Risk Screening (NRS). Results: The average age of the patients is 65.72 ± 20.79. The average fasting time of patients who underwent surgery was 10.82 ± 3.20 hours before surgery and 11.01 ± 10.84 hours after surgery. It was found that 31.7% of the patients were under the risk of malnutrition and not all of them received nutritional support. The mean age of the patients with malnutrition risk was higher (t =-4.087, p=0.000). Patients with malnutrition risk had longer periods of fasting before surgery than those without risk (t=-3.019, p=0.000). Patients who had undergone surgery and had malnutrition risk had their first mobilization in a longer period after surgery (t=-4.113, p=0.000). A statistically significant difference was found between the patients' albumin values and NRS scores (t=5.751, p=0.000). A statistically significant difference was found between the participants' gender (X2=4.809 p=0.028), education level (X2=10.358, p=0.0016), presence of chronic disease (X2=5.890, p=0.015) and infection (X2=7.566.5, p =0.006) and their NRS scores. Conclusion: In our study, it was found that approximately one out of three patients was at risk of malnutrition. Our research results showed that other risk factors affecting the malnutrition risk of patients are age, gender, education level of the patients, presence of comorbid disease, low albumin level, preoperative fasting period and postoperative infection development. In addition, it was found that the first postoperative mobilization period of patients with malnutrition risk was later. Nutritional support approaches should be standardized with a professional team approach in line with current guidelines.

Keywords:

Malnutrition, Nutritional Risk Screening, Orthopedics ve Traumatology.,

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