Gao Qiqing, Cheng Yao, Li Zhuohong, Tang Qingyun, Qiu Rong, Cai Shaohang, Xu Xuwen, Peng Jie, Xie Hongyan
Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China.
Infect Drug Resist. 2021 Sep 17;14:3817-3825. doi: 10.2147/IDR.S321385. eCollection 2021.
Malnutrition is one of the most critical factors affecting patients' risk of infection and length of stay, and it may affect the prognosis of patients with sepsis. There have been no studies that have applied nutritional risk screening tools to stratify patients with sepsis according to prognosis.
We retrospectively analyzed the clinical data of 425 adult sepsis inpatients who were grouped based on nutritional risk screening (NRS) score, including a nutrition score, disease severity score, and age score. Prognostic factors were analyzed using univariate and multivariate regression analyses.
Of the enrolled patients, 174 had an NRS score of ≥3; these patients were older and had a longer hospitalization time but lower body mass index (BMI), albumin (ALB) than others. Univariate Cox regression analysis showed that age, ALB, C-reactive protein (CRP), and NRS score were significantly (P<0.05) associated with in-hospital mortality. Multivariate analysis showed that age (hazard ratio [HR]=1.020, 95% confidence interval [CI]: 1.005-1.036; P=0.008) and ALB (HR=0.924, 95% CI: 0.885-0.966; P<0.001) were independent risk factors for sepsis-related mortality. The Kaplan-Meier analysis revealed that the cumulative in-hospital mortality of sepsis patients with an NRS score of ≥3 was significantly higher than that of patients with an NRS score of <3 (P=0.022).
NRS scores can effectively risk stratify sepsis patients. Patients with high NRS scores should be monitored more closely to halt further disease progression.
营养不良是影响患者感染风险和住院时间的最关键因素之一,可能影响脓毒症患者的预后。目前尚无研究应用营养风险筛查工具根据预后对脓毒症患者进行分层。
我们回顾性分析了425例成年脓毒症住院患者的临床资料,这些患者根据营养风险筛查(NRS)评分进行分组,NRS评分包括营养评分、疾病严重程度评分和年龄评分。采用单因素和多因素回归分析对预后因素进行分析。
在纳入的患者中,174例NRS评分≥3;这些患者年龄较大,住院时间较长,但体重指数(BMI)、白蛋白(ALB)低于其他患者。单因素Cox回归分析显示,年龄、ALB、C反应蛋白(CRP)和NRS评分与住院死亡率显著相关(P<0.05)。多因素分析显示,年龄(风险比[HR]=1.020,95%置信区间[CI]:1.005-1.036;P=0.008)和ALB(HR=0.924,95%CI:0.885-0.966;P<0.001)是脓毒症相关死亡的独立危险因素。Kaplan-Meier分析显示,NRS评分≥3的脓毒症患者的累积住院死亡率显著高于NRS评分<3的患者(P=0.022)。
NRS评分可有效对脓毒症患者进行风险分层。NRS评分高的患者应密切监测,以阻止疾病进一步发展。