握力测试和生物电阻抗分析在入住亚重症监护病房的 SARS-CoV-2 患者中的应用。

Handgrip Strength Test and Bioelectrical Impedance Analysis in SARS-CoV-2 Patients Admitted to Sub-Intensive Unit.

机构信息

Department of Medicine and Surgery, Internship Program in Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy.

Operative Research Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 21-00128 Roma, Italy.

出版信息

Nutrients. 2023 Apr 20;15(8):1979. doi: 10.3390/nu15081979.

Abstract

Hospitalized patients with respiratory failure due to SARS-CoV-2 pneumonia are at increased risk of malnutrition and related mortality. The predictive value of the Mini-Nutritional Assessment short form (MNA-sf), hand-grip strength (HGS), and bioelectrical impedance analysis (BIA) was determined with respect to in-hospital mortality or endotracheal intubation. The study included 101 patients admitted to a sub-intensive care unit from November 2021 to April 2022. The discriminative capacity of MNA-sf, HGS, and body composition parameters (skeletal mass index and phase angle) was assessed computing the area under the receiver operating characteristic curves (AUC). Analyses were stratified by age groups (<70/70+ years). The MNA-sf alone or in combination with HGS or BIA was not able to reliably predict our outcome. In younger participants, HGS showed a sensitivity of 0.87 and a specificity of 0.54 (AUC: 0.77). In older participants, phase angle (AUC: 0.72) was the best predictor and MNA-sf in combination with HGS had an AUC of 0.66. In our sample, MNA- sf alone, or in combination with HGS and BIA was not useful to predict our outcome in patients with COVID-19 pneumonia. Phase angle and HGS may be useful tools to predict worse outcomes in older and younger patients, respectively.

摘要

因 SARS-CoV-2 肺炎导致呼吸衰竭而住院的患者存在营养不良和相关死亡风险增加。使用迷你营养评估简表(MNA-sf)、握力(HGS)和生物电阻抗分析(BIA)来预测住院死亡率或气管插管的预测价值。这项研究纳入了 2021 年 11 月至 2022 年 4 月期间入住亚重症监护病房的 101 名患者。通过计算接受者操作特征曲线下的面积(AUC)来评估 MNA-sf、HGS 和身体成分参数(骨骼质量指数和相位角)的区分能力。分析按年龄组(<70/70+ 岁)进行分层。MNA-sf 单独或与 HGS 或 BIA 联合使用均无法可靠预测我们的结果。在年轻参与者中,HGS 的灵敏度为 0.87,特异性为 0.54(AUC:0.77)。在年龄较大的参与者中,相位角(AUC:0.72)是最佳预测指标,MNA-sf 联合 HGS 的 AUC 为 0.66。在我们的样本中,MNA-sf 单独或与 HGS 和 BIA 联合使用对于预测 COVID-19 肺炎患者的结局并不有用。相位角和 HGS 可能分别是预测老年和年轻患者预后较差的有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ea5/10142194/dcba1397869b/nutrients-15-01979-g001.jpg

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