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改良 NUTRIC 评分对预测重症社区获得性肺炎患者临床结局的意义。

Significance of the Modified NUTRIC Score for Predicting Clinical Outcomes in Patients with Severe Community-Acquired Pneumonia.

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.

Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 61363, Taiwan.

出版信息

Nutrients. 2021 Dec 31;14(1):198. doi: 10.3390/nu14010198.

Abstract

Nutritional status could affect clinical outcomes in critical patients. We aimed to determine the prognostic accuracy of the modified Nutrition Risk in Critically Ill (mNUTRIC) score for hospital mortality and treatment outcomes in patients with severe community-acquired pneumonia (SCAP) compared to other clinical prediction rules. We enrolled SCAP patients in a multi-center setting retrospectively. The mNUTRIC score and clinical prediction rules for pneumonia, as well as clinical factors, were calculated and recorded. Clinical outcomes, including mortality status and treatment outcome, were assessed after the patient was discharged. We used the receiver operating characteristic (ROC) curve method and multivariate logistic regression analysis to determine the prognostic accuracy of the mNUTRIC score for predicting clinical outcomes compared to clinical prediction rules, while 815 SCAP patients were enrolled. ROC curve analysis showed that the mNUTRIC score was the most effective at predicting each clinical outcome and had the highest area under the ROC curve value. The cut-off value for predicting clinical outcomes was 5.5. By multivariate logistic regression analysis, the mNUTRIC score was also an independent predictor of both clinical outcomes in SCAP patients. We concluded that the mNUTRIC score is a better prognostic factor for predicting clinical outcomes in SCAP patients compared to other clinical prediction rules.

摘要

营养状况可能会影响危重症患者的临床结局。我们旨在确定改良的危重症患者营养风险评分(mNUTRIC)对医院死亡率和严重社区获得性肺炎(SCAP)患者治疗结局的预后准确性,与其他临床预测规则进行比较。我们回顾性地在多中心环境中招募了 SCAP 患者。计算并记录了 mNUTRIC 评分和肺炎的临床预测规则以及临床因素。评估患者出院后的临床结局,包括死亡率和治疗结局。我们使用接收者操作特征(ROC)曲线方法和多变量逻辑回归分析来确定 mNUTRIC 评分与临床预测规则相比预测临床结局的预后准确性,同时纳入了 815 例 SCAP 患者。ROC 曲线分析表明,mNUTRIC 评分在预测每个临床结局方面最有效,ROC 曲线下面积值最高。预测临床结局的截断值为 5.5。通过多变量逻辑回归分析,mNUTRIC 评分也是 SCAP 患者临床结局的独立预测因素。我们得出结论,与其他临床预测规则相比,mNUTRIC 评分是预测 SCAP 患者临床结局的更好预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b9/8747298/8c4ede801479/nutrients-14-00198-g001.jpg

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