Chittawatanarat Kaweesak, Chaiwat Onuma, Morakul Sunthiti, Kongsayreepong Suneerat
J Med Assoc Thai. 2016 Sep;99 Suppl 6:S184-S192.
The objective of the study is to evaluate the nutrition assessment tool used by Bhumibol Nutrition Triage/Nutrition Triage (BNT/NT) for patient outcomes in a surgical intensive care unit (SICU).
All data were retrieved from the THAI-SICU database. A total of 1,685 patients from three medical centers were participants in the nutrition project and were enrolled onto this study. The parameters needed for BNT/NT scoring were recorded including body mass index (BMI), weight change, energy delivery, age, and disease severity. The BNT/NT calculation was classified into 4 groups as BNT/NT I to IV. An adjusted odds ratio (OR) with 95% confidence interval (CI) of mortality and sepsis occurrence were reported. Results were classed as being statistically significant at p<0.05.
Regarding the nutrition assessment classification, the patients admitted to SICU were classified as BNT/NT class I48.6%, class II 30.0%, class III 9.3%, and class IV 12.1%. There were statistically significant differences between classes in terms of BMI, weight change, energy delivery and disease severity. In addition, the BNT/NT classification was also significantly associated with ICU mortality [OR (95% CI): 1.51 (1.25-1.83); p<0.001], 28 day mortality [1.47 (1.23-1.74); p<0.001], and sepsis occurrence [1.41 (1.25-1.60); p<0.001].
Most of the patients admitted to SICU had a low nutrition risk BNT/NT class I and II. The higher BNT/NT scores were associated with mortality and sepsis occurrence in SICU.
本研究的目的是评估诗丽吉王后营养分诊/营养分诊(BNT/NT)所使用的营养评估工具对外科重症监护病房(SICU)患者预后的影响。
所有数据均从泰国SICU数据库中获取。来自三个医疗中心的1685名患者参与了营养项目并被纳入本研究。记录BNT/NT评分所需的参数,包括体重指数(BMI)、体重变化、能量供应、年龄和疾病严重程度。BNT/NT计算分为4组,即BNT/NT I至IV组。报告了死亡率和脓毒症发生率的调整比值比(OR)及95%置信区间(CI)。结果在p<0.05时被认为具有统计学意义。
关于营养评估分类,入住SICU的患者中,BNT/NT I类占48.6%,II类占30.0%,III类占9.3%,IV类占12.1%。在BMI、体重变化、能量供应和疾病严重程度方面,各分类之间存在统计学显著差异。此外,BNT/NT分类也与ICU死亡率[OR(95%CI):1.51(1.25 - 1.83);p<0.001]、28天死亡率[1.47(1.23 - 1.74);p<0.001]和脓毒症发生率[1.41(1.25 - 1.60);p<0.001]显著相关。
入住SICU的大多数患者营养风险较低,属于BNT/NT I类和II类。较高的BNT/NT评分与SICU中的死亡率和脓毒症发生率相关。