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基于营养风险筛查 2002 评分评估 ICU COVID-19 患者的营养状况。

Evaluation of Nutritional Status of Intensive Care Unit COVID-19 Patients Based on the Nutritional Risk Screening 2002 Score.

机构信息

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Clin Pract. 2022 Oct 17;2022:2448161. doi: 10.1155/2022/2448161. eCollection 2022.

Abstract

BACKGROUND

Patients with COVID-19 are susceptible to malnutrition, which is particularly concerning among critically ill patients. We evaluated the Nutritional Risk Screening 2002 (NRS-2002) score in such patients and determined its relationship with the hospitalization outcome.

METHODS

This cross-sectional study involved COVID-19 patients admitted to the intensive care units (ICUs) of Shahid Faghihi Hospital, Shiraz, Iran, between February and March 2021. We assessed the nutritional status using NRS-2002 and determined disease severity with the APACHE II index. Demographic information, weight, height, clinical signs, previous illness, medications, biochemical test results, and history of anorexia and weight loss were recorded. Data were analyzed using SPSS version 18.

RESULTS

The mean age of 100 patients was 55.36 ± 18.86 years. According to NRS-2002, 30%, 29%, and 41% of patients were at low risk, moderate risk, and high risk of malnutrition, respectively. Age and BUN increased significantly with NRS-2002, while albumin and hematocrit followed the opposite trend ( < 0.001). Patients who died had lower albumin and hematocrit levels but higher age, NRS-2002 scores, and BUN/creatinine levels than those who recovered. Multivariable logistic regression revealed that for every unit increase in the NRS-2002 score, the odds of mortality increased by 354% (OR: 4.54, CI: 1.48, 13.95, =0.008).

CONCLUSION

NRS-2002 is a valuable prognostic tool for critically ill COVID-19 patients, with each unit's rise in the score being associated with a 354% rise in the odds of mortality. Increased malnutrition risk was linked with higher age and BUN and lower albumin and hematocrit levels.

摘要

背景

COVID-19 患者易发生营养不良,危重症患者尤其如此。我们评估了此类患者的营养风险筛查 2002 评分(NRS-2002),并确定了其与住院结局的关系。

方法

本横断面研究纳入了 2021 年 2 月至 3 月期间在伊朗设拉子沙希德法希希医院重症监护病房(ICU)住院的 COVID-19 患者。我们使用 NRS-2002 评估营养状况,并使用急性生理学与慢性健康状况评分系统 II(APACHE II)评估疾病严重程度。记录人口统计学信息、体重、身高、临床体征、既往疾病、药物、生化检查结果以及厌食和体重减轻史。使用 SPSS 18 版本对数据进行分析。

结果

100 例患者的平均年龄为 55.36±18.86 岁。根据 NRS-2002,分别有 30%、29%和 41%的患者处于低危、中危和高危营养不良风险。NRS-2002 评分与年龄和血尿素氮(BUN)呈正相关,与白蛋白和红细胞比容呈负相关(均<0.001)。死亡患者的白蛋白和红细胞比容水平低于存活患者,年龄、NRS-2002 评分和 BUN/肌酐水平高于存活患者。多变量 logistic 回归分析显示,NRS-2002 评分每增加 1 个单位,死亡的几率增加 354%(比值比:4.54,95%置信区间:1.48,13.95,=0.008)。

结论

NRS-2002 是评估 COVID-19 危重症患者预后的有效工具,评分每增加 1 个单位,死亡的几率增加 354%。营养不良风险增加与年龄增加、BUN 升高以及白蛋白和红细胞比容降低有关。

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