NCM : Nutritional Care and Management: NCM NCM NCM NCM NCM NCM NCM NCM NCM. Nutritional Care and Management: NCM.

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1 219 Vol. 34, pp , 2006 NCM : Nutritional Care and Management: NCM , NCM NCM NCM NCM NCM NCM NCM NCM NCM 14 Nutritional Care and Management: NCM 56 QOL Quality Of Life: NCM a b 1 2 c NCM QOL 11 NCM 7

2 220 NCM NCM NCM , , , , NCM FAX 1 Body Mass Index: BMI18.5 kgm gdl Blood Urea Nitrogen BUN 30 mgdl Creatine Cr 2.0 mgdl SBP 140 mmhg DBP 90 mmhg NCM NCM NCM BMI BUN Cr BUNCr SBP DBP :BMI 0.3 kgm 2 : 0.5 gdl : BUN5 mgdl : 0.3 mgdl SBP10 mmhg DBP10 mmhg NCM 5 NCM : BMI18.5 kgm 2 : 3.5 gdl : BUN30 mgdl : 2.0 mgdl : 140 mmhg : 90 mmhg 8

3 NCM 221 Table 1. Frequency of Malnutritional Risk NCM SAS programs Version 8.02, SAS Institute Inc., Cary, NC, USA 13 6 NIPH-IBRA Table 1 Table Table 2 Table 2 NCM NCM NCM 39 8 NCM Table 3 Table 3 NCM SBP NCM DBP 9

4 222 Table 2. Proportion of Malnutritional Care Management for Risk Patients Table 4 Table 4 70 BUN BUNCr NCM SBP DBP NCM Table 5 Table 5 NCM odds CI: odds CI: SBP odds CI: odds NCM odds NCM Table 2 40 NCM 10 NCM NCM 39 NCM 14 NCM 1 71 NCM NCM Table 3 Table 4 NCM NCM 4 1 NCM NCM Cicci et al 15 NCM NCM

5 NCM 223 Table 3. Comparison of Malnutritional Risk Indicators between NCM Conducted Patients and Others 11

6 224 Table 4. Comparison of the Improvement Rates Indicators between NCM Conducted Patients and Others 12

7 NCM 225 Table 5. Logistic Analysis for Conducting NCM NCM NCM NCM Table 4 NCM NCM NCM NCM Table 5 40 SBP NCM NCM NCM NCM NCM NCM NCM 10 NCM NCM : 1 Stratton RJ, Green CJ and Elia M. Evidence based for oral nutritional support. Disease- Related Malnutrition, an Evidence-based approach to treatment. CABI Publishing, London, 2003: Protein energy malnutrition, PEM 2000; 3: Marian MJ and Allen P. Nutrition support for patients in long-term acute care and subacute care facilities. AACN Clin Issues 1998; 9:

8 226 4 Mobarhan S and Trumbore LS. Nutritional problems of the elderly. Clin Geriatr Med 1991; 7: ; 9: Sugiyama M, Nishimura A and Koyama H. The nutritional assessment and care for elderly in Japan. J Community Nutrition 2000; 2: NCM 1, 2003: Gallagher-Allred CR, Voss AC, Finn SC and McCamish MA. Malnutrition and clinical outcomes: the case for medical nutrition therapy. J Am Diet Assoc 1996; 96: Ockenga J, Freudenreich M, Zakonsky R, Norman K, Pirlich M and Lochs H. Nutritional assessment and management in hospitalised patients: implication for DRG-based reimbursement and health care quality. Clin Nutr 2005; 24: NCM 2006; 4: SAS Institute Inc. SAS User s Guide Statistics, Version6 First Edition, Cary, North Carolina, SAS Institute Inc ; 104: Cicci A, Sunyecz LA, Mirtallo J and Flancbaum LJ. A standardized system for assessment and delivery of nutrition support in a large teaching hospital. Nutr Clin Pract 1992; 7: ; 52: J Natl Inst Public Health 2006; 1: ; 32: : Rapid turnover protein RTP 2004; 48:

9 NCM 227 Abstract Present Status of Nutritional Care Management in Japanese Hospitals Masashi Nishihara 1, Toshiaki Tanaka 1, Katsumi Yoshida 1, and Akira Matsuda 2 Recently, the importance of nutritional management in inpatient medical care is attracting attention. It cannot be said that the present status of nutritional care and management NCM in Japanese hospitals is fully grasped. Four thousand one hundred forty-two patients mean age; years: age range; 17 to 98 years newly admitted to 122 acute hospitals during one week in November We examined the nutritional status and NCM activity items nutritional assessment, care guidance, goal setting, and reevaluation on admission to the hospital and their discharge. We analyzed the prevalence of nutritional risks, frequency of NCM activities executed, improvement of nutritional risks through NCM execution, and factors related to NCM execution. Nutritional risks are remarkable in patients over 40 years old su#ering from leanness, malnutrition, renal damage, especially patients over 70 years of age with severe leanness and malnutrition. The frequency of NCM activities, however, was low NCM execution rate 12.3 for leanness, 11.7 for malnutrition, for renal damage, 12.6 and 13.4 for hypertension. We did not observe any significant improvement of nutritional risks between the NCM execution group and non-execution group. In the current state of acute general hospitals, as factors related to the execution of NCM, age 4069 yo; odds ratio 2.153, 95 CI , over 70 yo; odds ratio 1.630, 95 CI and hypertension odds ratio 1.277, 95 CI had shown a significant influence of the execution of NCM. But we did not observe any significant relationship between leanness, malnutrition, and renal damage. We elucidated that the assessment of nutritional risks and the execution were insu$cient in the present Japanese hospitals. After further prevalence of NCM activities in inpatient care of hospital, appropriate nutritional care should be provided for patients with risks. Key Words Nutritional Care and Management NCM, hospital, nutritional risk, protein energy malnutrition PEM 1 Department of Preventive Medicine, St. Marianna University School of Medicine 2 The Employee[s Pension Welfare Corporation 15

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