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改良 NUTRIC 评分对评估重症监护病房患者预后的价值:前瞻性观察研究。

Prognostic values of modified NUTRIC score to assess outcomes in critically ill patients admitted to the intensive care units: prospective observational study.

机构信息

Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

Evidence Based Research center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

BMC Anesthesiol. 2023 Apr 20;23(1):131. doi: 10.1186/s12871-023-02086-0.

Abstract

PURPOSE

Modified Nutrition Risk in the Critically Ill (NUTRIC) score (mNUTRIC score) have been validated as screening tool for quantifying risk of adverse outcome critically ill patients admitted to the intensive care units (ICUs). The aim of this study was to evaluate the prognostic value of mNUTRIC score to assess outcomes in this population.

MATERIALS AND METHODS

This prospective, observational study was conducted on adult patients admitted to the general ICUs of two university affiliated hospital in northwest of Iran. The association between the mNUTRIC score and outcomes was assessed using the univariate and multivariate binary logistic regression. The performance of mNUTRIC score to predict outcomes was assessed using the receiver operating characteristic (ROC)-curve.

RESULTS

In total 445 ICU patients were enrolled. Based on mNUTRIC score, 62 (13.9%) and 383 (86.1%) individuals were identified at high and low nutritional risk, respectively. The area under the curve (AUC) for predicting ICU mortality, using vasopressor, duration of vasopressor, and mechanical ventilation (MV) duration were (AUC: 0.973, 95% CI: 0.954-0.986, P < 0.001), (AUC: 0.807, 95% CI: 0.767-0.843, P < 0.001), (AUC: 0.726, 95% CI: 0.680-0.769, P < 0.001) and (AUC: 0.710, 95% CI: 0.666-0.752, P < 0.001), respectively.

CONCLUSIONS

An excellent and good predictive performance of the mNUTRIC score was found regarding ICU mortality and using vasopressor, respectively. However, this predictive was fair for MV and vasopressor duration and poor for ICU and hospital length of stay.

摘要

目的

改良营养风险在危重症患者(NUTRIC)评分(mNUTRIC 评分)已被验证为量化危重症患者入住重症监护病房(ICU)不良预后风险的筛查工具。本研究的目的是评估 mNUTRIC 评分对该人群预后的预测价值。

材料与方法

本前瞻性观察性研究在伊朗西北部的两家大学附属医院的普通 ICU 病房对成年患者进行。使用单变量和多变量二项逻辑回归评估 mNUTRIC 评分与结局之间的关联。使用受试者工作特征(ROC)曲线评估 mNUTRIC 评分预测结局的性能。

结果

共纳入 445 例 ICU 患者。根据 mNUTRIC 评分,62 例(13.9%)和 383 例(86.1%)患者分别被确定为高营养风险和低营养风险。预测 ICU 死亡率、使用血管加压药、血管加压药持续时间和机械通气(MV)持续时间的曲线下面积(AUC)分别为(AUC:0.973,95%CI:0.954-0.986,P<0.001)、(AUC:0.807,95%CI:0.767-0.843,P<0.001)、(AUC:0.726,95%CI:0.680-0.769,P<0.001)和(AUC:0.710,95%CI:0.666-0.752,P<0.001)。

结论

mNUTRIC 评分对 ICU 死亡率和使用血管加压药的预测具有良好的预测性能。然而,该预测对 MV 和血管加压药持续时间的预测效果一般,对 ICU 和住院时间的预测效果较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6755/10116772/da38d63a80cb/12871_2023_2086_Fig1_HTML.jpg

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