营养师主导的基于IDDSI的饮食调整对神经康复患者营养结局的影响：一项回顾性研究
The effect of dietitian-controlled IDDSI-based diet modification on nutritional outcomes in patients undergoing neurological rehabilitation: A retrospective study.
文献信息
| PMID | 42893353 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Fatma Ballı Uz |
| 作者单位 | Department of Physical Medicine and Rehabilitation, University of Health Sciences, Etlik Physical Medicine and Rehabilitation City Hospital, Ankara, Turkey. |
| 期刊 | Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition |
| SCI 分区 | Q3 |
| IF | 3.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 本研究旨在评估基于IDDSI的质地调整与传统R1-2-3质地调整在神经康复患者中与营养结局的关联，这些患者在视频荧光吞咽检查（VFSS）后需要饮食调整。
材料与方法： 回顾性分析2023年2月至12月期间因神经康复住院并接受VFSS的患者。根据住院时期，患者接受传统R1-2-3饮食系统或基于IDDSI的调整。两组中，个体化能量和蛋白质需求由临床营养师确定。记录入院和出院时的体重指数（BMI）、NRS-2002评分、血液学参数和生化参数。进行了组内和组间比较及相关性分析。
结果： 共纳入288例患者（平均年龄60.59±19.26岁；44.8%为女性）。IDDSI组出院前BMI更高（p=0.046），而低蛋白和低白蛋白水平患者比例更低（分别为p=0.038和p=0.024）。血清25-羟基维生素D水平也更高（p=0.019）。IDDSI组在BMI、NRS-2002评分、营养风险、血红蛋白、总淋巴细胞计数和维生素D水平的改善更大（p=0.006-0.045）。基于IDDSI的调整与低体重BMI、营养风险、低蛋白和低白蛋白水平呈负相关（p<0.05）。
结论： 在营养师监督的营养护理中，基于IDDSI的质地调整与传统R1-2-3系统相比与更有利的营养相关结局相关。鉴于回顾性、非随机设计，这些发现不应被解释为因果关系的证据。
英文摘要
OBJECTIVE: This study aimed to evaluate the association between IDDSI-based versus traditional R1-2-3 texture modifications and nutritional outcomes in patients undergoing neurological rehabilitation who required dietary modification after videofluoroscopic swallowing study (VFSS).
MATERIALS AND METHODS: Patients hospitalized for neurological rehabilitation who underwent VFSS between February and December 2023 were retrospectively analyzed. Patients received either the traditional R1-2-3 diet system or IDDSI-based modification, according to the hospitalization period. In both groups, individualized energy and protein requirements were determined by a clinical dietitian. Body mass index (BMI), NRS-2002 scores, hematological parameters, and biochemical parameters were recorded at admission and discharge. Intra- and intergroup comparisons and correlation analyses were performed.
RESULTS: A total of 288 patients were included (mean age, 60.59 ± 19.26 years; 44.8% female). Pre-discharge BMI was higher in the IDDSI group (p = 0.046), while the proportions of patients with low protein and albumin levels were lower (p = 0.038 and p = 0.024, respectively). Serum 25-hydroxyvitamin D levels were also higher (p = 0.019). Improvements in BMI, NRS-2002 scores, nutritional risk, hemoglobin, total lymphocyte count, and vitamin D levels were greater in the IDDSI group (p = 0.006-0.045). IDDSI-based modification was negatively associated with underweight BMI, nutritional risk, low protein, and low albumin levels (p < 0.05).
CONCLUSION: Within dietitian-supervised nutritional care, IDDSI-based texture modification was associated with more favorable nutrition-related outcomes than the traditional R1-2-3 system. Given the retrospective, nonrandomized design, these findings should not be interpreted as evidence of causality.