影响老年住院患者ADL恢复程度的营养相关因素分析

Analysis of Nutrition-Related Factors Affecting ADL Recovery of Elderly Inpatients

摘要: 目的：探讨营养相关因素对老年住院患者日常生活活动能力(ADL)恢复程度的影响，为临床营养干预提供循证依据。方法：采用回顾性观察性研究设计，收集2024年1月至2025年12月于珠海市中西医结合医院脑外科住院的99例老年脑卒中患者的病历资料。根据Barthel指数(BI)变化值(ΔBI)将患者分为低恢复组(n = 73)和高恢复组(n = 26)。比较两组间年龄、性别、入院时格拉斯哥昏迷量表(GCS)评分、入院时BI评分、营养风险筛查2002 (NRS-2002)评分、血清白蛋白、总蛋白及血红蛋白水平的差异，并采用二元Logistic回归分析探讨影响ADL恢复程度的独立因素。结果：高恢复组入院时GCS评分、入院时BI评分、出院时BI评分及ΔBI均显著高于低恢复组(P < 0.01)，NRS-2002评分及营养风险比例显著低于低恢复组(P < 0.05)，血清白蛋白水平显著高于低恢复组(P < 0.05)。二元Logistic回归分析显示，血清白蛋白是影响ADL恢复程度的独立保护因素(OR = 1.211, 95% CI: 1.025~1.431, P < 0.05)，而NRS-2002评分未显示独立预测价值(P > 0.05)。结论：入院时血清白蛋白水平是影响老年脑卒中住院患者ADL恢复程度的独立保护因素，早期营养评估与针对性干预对促进患者功能恢复具有重要意义。

Abstract: Objective: To explore the influence of nutrition-related factors on the recovery of activities of daily living (ADL) in elderly inpatients, and to provide evidence-based evidence for clinical nutrition intervention. Methods: A retrospective observational study design was used to collect the medical records of 99 elderly stroke patients hospitalized in brain surgery department of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2024 to December 2025. Patients were divided into low recovery group (n = 73) and high recovery group (n = 26) according to the change value (δ BI) of Barthel index (BI). The differences of age, sex, Glasgow coma scale (GCS) score at admission, BI score at admission, nutritional risk screening 2002 (NRS-2002) score, serum albumin, total protein and hemoglobin levels between the two groups were compared, and the independent factors affecting the recovery degree of ADL were discussed by binary Logistic regression analysis. Results: The GCS score at admission, BI score at admission, BI score at discharge and δ BI in high recovery group were significantly higher than those in low recovery group (P < 0.01), the NRS-2002 score and nutritional risk ratio were significantly lower than those in low recovery group (P < 0.05), and the serum albumin level was significantly higher than that in low recovery group (P < 0.05). Logistic regression analysis showed that serum albumin was an independent protective factor affecting the recovery of ADL (OR = 1.211, 95% CI: 1.025 ~ 1.431, P < 0.05), while NRS-2002 score showed no independent predictive value (P > 0.05). Conclusion: Serum albumin level at admission is an independent protective factor affecting the recovery of ADL in elderly stroke inpatients, and early nutritional assessment and targeted intervention are of great significance to promote the functional recovery of patients.