Emergency department of China rehabilitation research center, Capital Medical University, no.10 Jiaomen north Street, Fengtai District, Beijing, 100068, China.
Emergency department of Fu Xing Hospital, Capital Medical University, no. 20 Fuxingmenwai Street, Xicheng District, Beijing, 100038, China.
BMC Nephrol. 2022 Oct 18;23(1):335. doi: 10.1186/s12882-022-02949-7.
Malnutrition is common in critically ill patients, but nutrition status in critically ill patients with acute kidney injury (AKI) has been poorly studied. Our study aimed to investigate the relationship between malnutrition risk and the occurrence and prognosis of AKI in elderly patients in the intensive care unit (ICU).
Data were extracted from the Beijing Acute Kidney Injury Trial (BAKIT). A total of 1873 elderly patients were included and compared according to the clinical characteristics of AKI and non-AKI groups, and those of survivors and non-survivors of AKI in this study. Receiver operating characteristic (ROC) curves were used to analyse the predictive value of the modified Nutrition Risk in Critically Ill (mNUTRIC) score for the occurrence and 28-day prognosis of AKI. Multivariate Cox regression analysis was used to evaluate the effect of the mNUTRIC score on the 28-day mortality in AKI patients.
Compared with the non-AKI group, AKI patients had higher mNUTRIC scores, and non-survivors had higher mNUTRIC scores than survivors in AKI population. Moreover, multivariate Cox regression showed that 28-day mortality in AKI patients increased by 9.8% (95% CI, 1.018-1.184) for every point increase in the mNUTRIC score, and the mNUTRIC score had good predictive ability for the occurrence of AKI and 28-day mortality in AKI patients. The mortality of AKI patients with mNUTRIC > 4 was significantly increased.
The elderly patients are at high risk of malnutrition, which affects the occurrence and prognosis of AKI. Adequate attention should be given to the nutritional status of elderly patients.
This study was registered at www.chictr.org.cn (registration number Chi CTR-ONC-11001875) on 14 December 2011.
危重症患者普遍存在营养不良，但急性肾损伤（AKI）危重症患者的营养状况研究甚少。本研究旨在探讨营养风险与 ICU 老年患者 AKI 发生及预后的关系。
数据来自北京急性肾损伤临床试验（BAKIT）。共纳入 1873 例老年患者，根据 AKI 和非 AKI 组、AKI 存活组和非存活组的临床特征进行比较。受试者工作特征（ROC）曲线用于分析改良危重症营养风险指数（mNUTRIC）评分对 AKI 发生和 28 天预后的预测价值。多变量 Cox 回归分析用于评估 mNUTRIC 评分对 AKI 患者 28 天死亡率的影响。
与非 AKI 组相比，AKI 患者的 mNUTRIC 评分较高，AKI 患者中，非存活者的 mNUTRIC 评分高于存活者。此外，多变量 Cox 回归显示，mNUTRIC 评分每增加 1 分，AKI 患者 28 天死亡率增加 9.8%（95%CI，1.018-1.184），mNUTRIC 评分对 AKI 的发生和 28 天死亡率具有良好的预测能力。mNUTRIC>4 的 AKI 患者死亡率显著增加。
老年患者存在较高的营养不良风险，影响 AKI 的发生和预后。应充分重视老年患者的营养状况。
本研究于 2011 年 12 月 14 日在中国临床试验注册中心（Chi CTR-ONC-11001875）注册。
