集中治療室に入室した術後患者に対する早期経口摂取開始が入院期間に及ぼす影響評価

• 資料種別: 博士論文
• タイトル: 集中治療室に入室した術後患者に対する早期経口摂取開始が入院期間に及ぼす影響評価
• 著者・編者: 竹元, 明子
• 著者標目: 竹元, 明子
• 出版事項: Wolters Kluwer Health
• 出版年月日等: 2025-07-10
• 出版年（W3CDTF）: 2025-07-10
• 並列タイトル等: Early Initiation of Oral Intake on Length of Hospital Stay in Postoperative Patients Admitted to the Intensive Care Unit
• 授与機関名: 鹿児島大学
• 授与年月日: 2025-07-10
• 授与年月日（W3CDTF）: 2025-07-10
• 報告番号: 甲総研第793号
• 学位: 博士(医学)
• 本文の言語コード: eng
• 件名標目: early oral intake; ICU; length of hospital stay; MDC; nutrition management
• 対象利用者: 一般
• 一般注記: 出版タイプ： VoR; 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨; Early oral intake is recommended for postoperative recovery. We determined whether early oral intake affects postoperative hospital stay. Using the diagnosis procedure combination system introduced in Japan in 2003, patients were classified into major diagnostic categories (MDC) to determine whether the postoperative start date of oral nutrition reduces the postoperative length of hospital stay. A total of 491 patients (age range,15–94 years; median, 72 years; male = 316; female = 175) were analyzed, or which 341 cases of MDC05 (cardiovascular diseases) and 150 cases of MDC06 (digestive system diseases, liver, biliary, and pancreatic disease) were admitted to the intensive care unit. The patients were divided into 2 groups: the non-elderly group, <65 years old, and the elderly group, ≥65 years old. Multivariate analysis was conducted to identify the factors influencing the length of postoperative hospital stay. Explanatory variables included body mass index (18.5–24.9), geriatric nutritional risk index ≥ 98, C-reactive protein, postoperative start date of enteral nutrition, postoperative start date of oral nutrition, meal intake rate, medical resources, and nutrition and meal guidance. In MDC05 and MDC06, initiating oral intake early postoperatively significantly contributed to reducing the postoperative number of days of hospital stay (MDC05, all; β = 0.256, P < .001, non-elderly; β = 0.440, P < .001, elderly; β = 0.240, P < .001: MDC06, all; β = 0.563, P < .001, non-elderly; β = 0.552, P < .001, elderly; β = 0.528, P < .001). In the non-elderly group of MDC06, a body mass index of 18.5–24.9 influenced the shorter postoperative number of days of hospital stay (β = −0.320, P = .011). Nutritional management to promote early oral intake is crucial for optimizing the duration of hospital stay in postoperative patients admitted to the intensive care unit. This study demonstrated the importance of preadmission nutritional management.; Takemoto Akiko, Fukuda Yukari, Iwaanakuchi Takashi, Yoshida Takuma, Yamaguchi Taihei, Uto YumikoEarly initiation of oral intake on length of hospital stay in postoperative patients admitted to the intensive care unitMedicine 104(17):p e42224, April 25, 2025.https://doi.org/10.1097/MD.0000000000042224
• 国立国会図書館永続的識別子: info:ndljp/pid/14551091; https://dl.ndl.go.jp/pid/14551091
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2025-11-07T22:06:05+09:00
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://hdl.handle.net/10232/0002001431
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp