Advances in research of malnutrition in elderly patients attending emergency department_West China Medical Journal

Authors：

YANG Meng ^1,2 , GUO Mingxia ^1,2 , XU Jianwen ^1,2 ,  ZHANG Shu ¹

1. Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHANG Shu, Email: zhangs@wchscu.cn

Keywords：

Emergency department; elderly patients; malnutrition; malnutrition risk; nutritional assessment

DOI：

10.7507/1002-0179.202410099

Video：

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Abstract Full text Figures/Tables Video References Cited by

Currently, the aging population in China is severe, and the number of elderly patients with diseases has increased accordingly. In the emergency department, middle-aged and elderly patients account for a relatively high proportion, and malnutrition is prevalent among elderly patients, which affects their health and clinical outcomes from various aspects. However, the attention of emergency medical staff to malnutrition is far lower than that of the diseases themselves in elderly patients, and the screening and evaluation of malnutrition are far lower than those of other specialties and inpatient departments. Therefore, this paper expounds the epidemiological status, nutritional assessment, diagnosis, treatment and influencing factors of malnutrition in elderly patients in emergency department, in order to help emergency medical staff strengthen the attention and intervention of elderly malnutrition patients.

Citation： YANG Meng, GUO Mingxia, XU Jianwen, ZHANG Shu. Advances in research of malnutrition in elderly patients attending emergency department. West China Medical Journal, 2025, 40(11): 1869-1873. doi: 10.7507/1002-0179.202410099 Copy

1.	程萌, 梁瀟, 孫雪蓮, 等. 北京市某三甲醫院急診科老年患者流行病學特點. 中華老年多器官疾病雜志, 2023, 22(4): 268-273.
2.	左冬晶, 劉敏, 馬帥, 等. 某院急診醫學科近 3 年就診患者疾病譜分析. 中國病案, 2024, 25(8): 25-28.
3.	Rodríguez-Sánchez B, Sulo S, Carnicero JA, et al. Malnutrition prevalence and burden on healthcare resource use among spanish community-living older adults: results of a longitudinal analysis. Clinicoecon Outcomes Res, 2020, 12: 355-367.
4.	王見寶, 張紅雨. 老年住院患者營養狀況調查及營養干預分析. 山東第一醫科大學(山東省醫學科學院)學報, 2024, 45(6): 336-340.
5.	王秦怡, 管靈芝, 錢穎, 等. 急診老年患者衰弱現況及影響因素的調查研究. 中華急危重癥護理雜志, 2023, 4(4): 359-363.
6.	梁海艷. 中國人口的新特征、新趨勢與思考——基于 2020 年第七次全國人口普查公報數據的分析. 曲靖師范學院學報, 2021, 40(4): 97-103.
7.	屈莉, 曾令霞, 孔淑貞, 等. 急診住院患者 5243 例疾病譜調查分析. 陜西醫學雜志, 2016, 45(5): 626-628.
8.	潘潔, 崔紅元, 朱明煒, 等. 老年患者住院和出院時營養風險和應用量表的營養不良檢出率多中心對比調查研究. 中華臨床營養雜志, 2019, 27(2): 65-69.
9.	Vivanti A, Isenring E, Baumann S, et al. Emergency department malnutrition screening and support model improves outcomes in a pilot randomised controlled trial. Emerg Med J, 2015, 32(3): 180-183.
10.	Gentile S, Lacroix O, Durand AC, et al. Malnutrition: a highly predictive risk factor of short-term mortality in elderly presenting to the emergency department. J Nutr Health Aging, 2013, 17(4): 290-294.
11.	Pereira GF, Bulik CM, Weaver MA, et al. Malnutrition among cognitively intact, noncritically ill older adults in the emergency department. Ann Emerg Med, 2015, 65(1): 85-91.
12.	Morris AM, Engelberg Anderson JK, Schmitthenner B, et al. Leveraging emergency department visits to connect older adults at risk for malnutrition and food insecurity to community resources: design and protocol development for the BRIDGE study. Pilot Feasibility Stud, 2020, 6: 36.
13.	Burks CE, Jones CW, Braz VA, et al. Risk factors for malnutrition among older adults in the emergency department: a multicenter study. J Am Geriatr Soc, 2017, 65(8): 1741-1747.
14.	Cederholm T, Jensen GL, Correia MITD, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr, 2019, 38(1): 1-9.
15.	石漢平, 叢明華, 陳偉. 再論營養不良的三級診斷. 中國醫學前沿雜志, 2020, 12(1): 1-7, 159.
16.	Schindler K, Pernicka E, Laviano A, et al. How nutritional risk is assessed and managed in European hospitals: a survey of 21, 007 patients findings from the 2007-2008 cross-sectional nutritionDay survey. Clin Nutr, 2010, 29(5): 552-559.
17.	Schuetz P, Fehr R, Baechli V, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet, 2019, 393(10188): 2312-2321.
18.	Heyland DK, Patel J, Compher C, et al. The effect of higher protein dosing in critically ill patients with high nutritional risk (EFFORT Protein): an international, multicentre, pragmatic, registry-based randomised trial. Lancet, 2023, 401(10376): 568-576.
19.	Singer P, Blaser AR, Berger MM, et al. ESPEN practical and partially revised guideline: clinical nutrition in the intensive care unit. Clin Nutr, 2023, 42(9): 1671-1689.
20.	Kreymann KG, Berger MM, Deutz NE, et al. ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr, 2006, 25(2): 210-223.
21.	Singer P, Berger MM, Van den Berghe G, et al. ESPEN guidelines on parenteral nutrition: intensive care. Clin Nutr, 2009, 28(4): 387-400.
22.	Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
23.	McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A. S. P. E. N. ). JPEN J Parenter Enteral Nutr, 2016, 40(2): 159-211.
24.	Compher C, Bingham AL, McCall M, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: the American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr, 2022, 46(1): 12-41.
25.	de Man AME, Gunst J, Reintam Blaser A. Nutrition in the intensive care unit: from the acute phase to beyond. Intensive Care Med, 2024, 50(7): 1035-1048.
26.	富輝, 孔慶鵬. 人類健康增齡的發生機制——來自長壽人群的研究證據. 中國醫學前沿雜志(電子版), 2024, 16(8): 23-28.
27.	曹豐, 王亞斌, 薛萬國, 等. 中國老年疾病臨床多中心報告. 中華老年多器官疾病雜志, 2018, 17(11): 801-808.
28.	劉暢, 陳鳴聲. 我國中老年慢性病患者共病網絡與模式分析. 中國衛生經濟, 2024, 43(8): 57-60, 65.
29.	劉曄, 歐陽曉俊, 蔡曉真, 等. 內科老年住院患者營養狀況及其影響因素分析. 中國臨床保健雜志, 2019, 22(2): 174-178.
30.	Zhou HJ, Zuo DJ, Zhang D, et al. Nutritional status and prognostic factors for mortality in patients admitted to emergency department observation units: a national multi-center study in China. World J Emerg Med, 2023, 14(1): 17-24.
31.	徐曼玉, 羅瑩, 李道鴻, 等. 住院老年慢性病共病患者營養不良的影響因素及預測模型構建. 實用臨床醫藥雜志, 2024, 28(17): 73-78.
32.	Stumpf F, Keller B, Gressies C, et al. Inflammation and nutrition: friend or foe?. Nutrients, 2023, 15(5): 1159.
33.	Santos TBND, Fonseca LC, Tedrus GMAS, et al. Alzheimer’s disease: nutritional status and cognitive aspects associated with disease severity. Nutr Hosp, 2018, 35(6): 1298-1304.
34.	歐陽雁玲, 尹尚菁. 我國老年癡呆流行現狀及防治策略研究. 中國軟科學, 2019(6): 50-58.
35.	劉妮, 韓正風. 老年住院患者認知衰弱的影響因素及預防策略分析. 實用預防醫學, 2024, 31(6): 685-689.
36.	張媛, 史凌云, 吳瑞凱, 等. 老年病科住院患者輕度認知功能障礙的影響因素分析. 預防醫學, 2024, 36(4): 299-303.
37.	郭佩佩, 杜偉, 劉青. 急診留觀老年病人疾病不確定感與恐懼疾病進展的相關性研究. 全科護理, 2024, 22(12): 2351-2354.
38.	李娜, 劉惠萍, 白潔. 老年帕金森病患者營養不良現狀及與抑郁癥狀、社會疏離的關系. 中國健康心理學雜志, 2025, 33(2): 182-186.
39.	孫菊梅, 李林超, 劉晨, 等. 社會經濟地位對流動老年人衛生服務利用的影響分析. 中國預防醫學雜志, 2024, 25(5): 526-531.
40.	Dent E, Wright ORL, Woo J, et al. Malnutrition in older adults. Lancet, 2023, 401(10380): 951-966.
41.	中國老年護理聯盟, 中南大學湘雅護理學院(中南大學湘雅泛海健康管理研究院), 中南大學湘雅醫院(國家老年疾病臨床醫學研究中心), 等. 營養不良老年人非藥物干預臨床實踐指南. 中國全科醫學, 2023, 26(17): 2055-2069.
42.	商娜, 王娜, 劉慧珍, 等. 營養相關參數對急診老年患者衰弱的預測價值研究. 中國全科醫學, 2023, 26(23): 2842-2847.
43.	Prokopidis K, Tessier AJ, Ragusa FS, et al. Relationship between nutritional status and depression in elderly adults: a systematic review and meta-analysis. J Am Med Direct Assoc, 2019, 20(7): 807-813.
44.	Thomson KH, Rice S, Arisa O, et al. Effectiveness and cost-effectiveness of oral nutritional supplements in frail older people who are malnourished or at risk of malnutrition: a systematic review and meta-analysis. Lancet Healthy Longev, 2022, 3(10): e654-e666.

1. 程萌, 梁瀟, 孫雪蓮, 等. 北京市某三甲醫院急診科老年患者流行病學特點. 中華老年多器官疾病雜志, 2023, 22(4): 268-273.
2. 左冬晶, 劉敏, 馬帥, 等. 某院急診醫學科近 3 年就診患者疾病譜分析. 中國病案, 2024, 25(8): 25-28.
3. Rodríguez-Sánchez B, Sulo S, Carnicero JA, et al. Malnutrition prevalence and burden on healthcare resource use among spanish community-living older adults: results of a longitudinal analysis. Clinicoecon Outcomes Res, 2020, 12: 355-367.
4. 王見寶, 張紅雨. 老年住院患者營養狀況調查及營養干預分析. 山東第一醫科大學(山東省醫學科學院)學報, 2024, 45(6): 336-340.
5. 王秦怡, 管靈芝, 錢穎, 等. 急診老年患者衰弱現況及影響因素的調查研究. 中華急危重癥護理雜志, 2023, 4(4): 359-363.
6. 梁海艷. 中國人口的新特征、新趨勢與思考——基于 2020 年第七次全國人口普查公報數據的分析. 曲靖師范學院學報, 2021, 40(4): 97-103.
7. 屈莉, 曾令霞, 孔淑貞, 等. 急診住院患者 5243 例疾病譜調查分析. 陜西醫學雜志, 2016, 45(5): 626-628.
8. 潘潔, 崔紅元, 朱明煒, 等. 老年患者住院和出院時營養風險和應用量表的營養不良檢出率多中心對比調查研究. 中華臨床營養雜志, 2019, 27(2): 65-69.
9. Vivanti A, Isenring E, Baumann S, et al. Emergency department malnutrition screening and support model improves outcomes in a pilot randomised controlled trial. Emerg Med J, 2015, 32(3): 180-183.
10. Gentile S, Lacroix O, Durand AC, et al. Malnutrition: a highly predictive risk factor of short-term mortality in elderly presenting to the emergency department. J Nutr Health Aging, 2013, 17(4): 290-294.
11. Pereira GF, Bulik CM, Weaver MA, et al. Malnutrition among cognitively intact, noncritically ill older adults in the emergency department. Ann Emerg Med, 2015, 65(1): 85-91.
12. Morris AM, Engelberg Anderson JK, Schmitthenner B, et al. Leveraging emergency department visits to connect older adults at risk for malnutrition and food insecurity to community resources: design and protocol development for the BRIDGE study. Pilot Feasibility Stud, 2020, 6: 36.
13. Burks CE, Jones CW, Braz VA, et al. Risk factors for malnutrition among older adults in the emergency department: a multicenter study. J Am Geriatr Soc, 2017, 65(8): 1741-1747.
14. Cederholm T, Jensen GL, Correia MITD, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr, 2019, 38(1): 1-9.
15. 石漢平, 叢明華, 陳偉. 再論營養不良的三級診斷. 中國醫學前沿雜志, 2020, 12(1): 1-7, 159.
16. Schindler K, Pernicka E, Laviano A, et al. How nutritional risk is assessed and managed in European hospitals: a survey of 21, 007 patients findings from the 2007-2008 cross-sectional nutritionDay survey. Clin Nutr, 2010, 29(5): 552-559.
17. Schuetz P, Fehr R, Baechli V, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet, 2019, 393(10188): 2312-2321.
18. Heyland DK, Patel J, Compher C, et al. The effect of higher protein dosing in critically ill patients with high nutritional risk (EFFORT Protein): an international, multicentre, pragmatic, registry-based randomised trial. Lancet, 2023, 401(10376): 568-576.
19. Singer P, Blaser AR, Berger MM, et al. ESPEN practical and partially revised guideline: clinical nutrition in the intensive care unit. Clin Nutr, 2023, 42(9): 1671-1689.
20. Kreymann KG, Berger MM, Deutz NE, et al. ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr, 2006, 25(2): 210-223.
21. Singer P, Berger MM, Van den Berghe G, et al. ESPEN guidelines on parenteral nutrition: intensive care. Clin Nutr, 2009, 28(4): 387-400.
22. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
23. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A. S. P. E. N. ). JPEN J Parenter Enteral Nutr, 2016, 40(2): 159-211.
24. Compher C, Bingham AL, McCall M, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: the American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr, 2022, 46(1): 12-41.
25. de Man AME, Gunst J, Reintam Blaser A. Nutrition in the intensive care unit: from the acute phase to beyond. Intensive Care Med, 2024, 50(7): 1035-1048.
26. 富輝, 孔慶鵬. 人類健康增齡的發生機制——來自長壽人群的研究證據. 中國醫學前沿雜志(電子版), 2024, 16(8): 23-28.
27. 曹豐, 王亞斌, 薛萬國, 等. 中國老年疾病臨床多中心報告. 中華老年多器官疾病雜志, 2018, 17(11): 801-808.
28. 劉暢, 陳鳴聲. 我國中老年慢性病患者共病網絡與模式分析. 中國衛生經濟, 2024, 43(8): 57-60, 65.
29. 劉曄, 歐陽曉俊, 蔡曉真, 等. 內科老年住院患者營養狀況及其影響因素分析. 中國臨床保健雜志, 2019, 22(2): 174-178.
30. Zhou HJ, Zuo DJ, Zhang D, et al. Nutritional status and prognostic factors for mortality in patients admitted to emergency department observation units: a national multi-center study in China. World J Emerg Med, 2023, 14(1): 17-24.
31. 徐曼玉, 羅瑩, 李道鴻, 等. 住院老年慢性病共病患者營養不良的影響因素及預測模型構建. 實用臨床醫藥雜志, 2024, 28(17): 73-78.
32. Stumpf F, Keller B, Gressies C, et al. Inflammation and nutrition: friend or foe?. Nutrients, 2023, 15(5): 1159.
33. Santos TBND, Fonseca LC, Tedrus GMAS, et al. Alzheimer’s disease: nutritional status and cognitive aspects associated with disease severity. Nutr Hosp, 2018, 35(6): 1298-1304.
34. 歐陽雁玲, 尹尚菁. 我國老年癡呆流行現狀及防治策略研究. 中國軟科學, 2019(6): 50-58.
35. 劉妮, 韓正風. 老年住院患者認知衰弱的影響因素及預防策略分析. 實用預防醫學, 2024, 31(6): 685-689.
36. 張媛, 史凌云, 吳瑞凱, 等. 老年病科住院患者輕度認知功能障礙的影響因素分析. 預防醫學, 2024, 36(4): 299-303.
37. 郭佩佩, 杜偉, 劉青. 急診留觀老年病人疾病不確定感與恐懼疾病進展的相關性研究. 全科護理, 2024, 22(12): 2351-2354.
38. 李娜, 劉惠萍, 白潔. 老年帕金森病患者營養不良現狀及與抑郁癥狀、社會疏離的關系. 中國健康心理學雜志, 2025, 33(2): 182-186.
39. 孫菊梅, 李林超, 劉晨, 等. 社會經濟地位對流動老年人衛生服務利用的影響分析. 中國預防醫學雜志, 2024, 25(5): 526-531.
40. Dent E, Wright ORL, Woo J, et al. Malnutrition in older adults. Lancet, 2023, 401(10380): 951-966.
41. 中國老年護理聯盟, 中南大學湘雅護理學院(中南大學湘雅泛海健康管理研究院), 中南大學湘雅醫院(國家老年疾病臨床醫學研究中心), 等. 營養不良老年人非藥物干預臨床實踐指南. 中國全科醫學, 2023, 26(17): 2055-2069.
42. 商娜, 王娜, 劉慧珍, 等. 營養相關參數對急診老年患者衰弱的預測價值研究. 中國全科醫學, 2023, 26(23): 2842-2847.
43. Prokopidis K, Tessier AJ, Ragusa FS, et al. Relationship between nutritional status and depression in elderly adults: a systematic review and meta-analysis. J Am Med Direct Assoc, 2019, 20(7): 807-813.
44. Thomson KH, Rice S, Arisa O, et al. Effectiveness and cost-effectiveness of oral nutritional supplements in frail older people who are malnourished or at risk of malnutrition: a systematic review and meta-analysis. Lancet Healthy Longev, 2022, 3(10): e654-e666.

West China Medical Journal

Advances in research of malnutrition in elderly patients attending emergency department

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