영양집중지원팀 활동의 효과 분석 -내과중환자실입원환자를 대상으로- = Effect of Nutrition Support Team (NST) Management - in Medical Intensive Care Unit Patients -

다국어 초록 (Multilingual Abstract)

The purpose of this study is to compare the NST (nutrition support team) group with the non-NST group and to examine how the NST’s intervention influences clinically important end points of critically ill patients. NST group (n=50) who admitted to medical ICU from September to October 2014, was provided support by nutrition support team management. Non-NST group (n=50) who admitted to medical ICU (intensive care unit) from May to July 2014, was not. The assessment of nutritional status based on serum albumin and total lymphocyte count showed that 84.0～86.0% of those enrolled were at malnutrition. Changes in biochemistry index and mortality were not statistically significant, but there were significant difference in lengths of ICU stay (p=.007), hospital stay (p=.031) between two groups. In NST group, higher ratio of energy delivery resulted in significant decrease of length of ICU stay (p=.023)). Also higher ratio of protein delivery resulted in significant decrease in lengths of ICU stay (p=.031), hospital stay (p=.006). In conclusion, most critically ill patients were receiving less energy and protein than they required. It is necessary to make efforts for providing proper nutritional support to patients through more systematic NST activities and advertisement.

국문 초록 (Abstract)

본 연구는 영양집중지원팀(NST) 활동에 대한 효과를 파악하기 위하여 B시의 P대학병원의 내과중환자실에 입원한 19세 이상의 환자를 대상으로 전자의무기록을 후향적으로 검토한 서술적 조사 연구이다. 영양집중지원팀의 관리를 받은 환자군(NST군) 50명과 영양집중지원팀의 관리를 받지 못한 환자군(Non-NST군) 50명의 영양지원현황, 생화학지표, 합병증발생, 병원재원일수와 중환자실 재실일수, 사망률을 비교하였다. 자료분석방법은 빈도, 백분율, 평균, 표준편차, 카이제곱검정, t-검정, Pearson 상관계수로 분석하였다. NST군과 Non-NST군의 생화학지표에는 유의한 차이가 없었으며, 합병증발생은 신기능 이상에서만 유의한 차이가 있었다(t=7.679, p=.021). 병원재원일수는 NST군 25.66일, Non-NST군 38.40일로 유의한 차이가 있었으며(t=-2.207, p=.031), 중환자실 재실일수도 NST군 12.96일, Non-NST군 20.76일로 유의한 차이가 있었다(t=-2.747, p=.007). 사망률에서는 NST군과 Non-NST군에서 유의한 차이가 없었다. NST군에서 영양요구량 대비 에너지 공급(r=-0.322, p=.023)과 단백질 공급(r=-0.380, p=.006)이 증가할수록 병원재원일수가 유의하게 감소하였다. 결론적으로 영양집중지원팀의 관리를 받은 NST군이 병원재원일수와 중환자실 재실일수가 짧은 것으로 나타나 중환자의 영양집중지원팀의 역할의 중요성을 인지하고 영양집중지원팀의 활성 도모를 위해 적극적인 지원과 관심이 필요하겠다.

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