白蛋白-中性粒细胞与淋巴细胞比值（Albumin-dNLR）评分可作为判定70岁以上内科住院患者中GLIM炎症负担的病因学标准：一项多中心回顾性研究。
Albumin-dNLR score could be an etiological criterion to determine inflammation burden for GLIM in medical inpatients over 70 years old: A multicenter retrospective study.
作者信息
Xu Jingyong, Hu Yifu, Wang Lijuan, Li Pengxue, Zhu Mingwei, Song Jinghai, Wei Junmin
机构信息
Department of Hepatobiliary and Pancreatic Surgery, Peking University First Hospital, Beijing, China.
Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
Heliyon. 2024 Jul 4;10(13):e34102. doi: 10.1016/j.heliyon.2024.e34102. eCollection 2024 Jul 15.
AIM
To validate the role of the albumin-derived neutrophil-to-lymphocyte (ALB-dNLR) score in diagnosing malnutrition in medical inpatients over 70 years old.
METHODS
This is a retrospective cross-sectional study involving 7 departments from 14 Chinese hospitals. The ALB-dNLR score was calculated, and outcomes between groups with positive and negative ALB-dNLR scores were compared after propensity score matching (PSM). Afterwards, the outcomes were compared between the groups receiving nutrition support and those not receiving support among malnourished patients diagnosed using the Global Leadership Initiative Malnutrition (GLIM) criteria after PSM.
RESULTS
Out of 10,184 cases, 6165 were eligible. 2200 cases were in the positive ALB-dNLR score group. After PSM, 1458 pairs were analyzed, showing lower in-hospital mortality (0.8 % vs. 2.1 %, p = 0.005) and a lower nosocomial infection rate (5.9 % vs. 11.0 %, p < 0.001) in the negative ALB-dNLR score group. In malnourished patients, 259 pairs were analyzed after PSM. It showed better outcomes in mortality (0.8 % vs. 3.5 %, p = 0.033), nosocomial infection rate (5.4 % vs. 15.4 %, p < 0.001), length of stay (LOS) (13.8 ± 10.3 vs. 18.4 ± 14.1, p < 0.001), and total hospital cost (3315.3 ± 2946.4 vs. 4795.3 ± 4198.2, p < 0.001) in the support group. In malnourished patients with ALB-dNLR score as the sole etiological criterion, 94 pairs were calculated. It showed better outcomes in mortality (0.0 % vs. 6.4 %, p = 0.029), nosocomial infection rate (7.4 % vs. 18.1 %, p = 0.029), LOS (13.7 ± 8.3 vs. 19.8 ± 15.2, p = 0.001), and total hospital cost (3379.3 ± 2955.6 vs. 4471.2 ± 4782.4, p = 0.029) in the support group.
CONCLUSIONS
The ALB-dNLR score was validated to predict in-hospital mortality in medical inpatients over 70 years old. Malnutrition patients diagnosed by the GLIM criteria and using the ALB-dNLR score might benefit from nutrition support.
目的
验证白蛋白衍生的中性粒细胞与淋巴细胞比值（ALB-dNLR）评分在诊断70岁以上内科住院患者营养不良中的作用。
方法
这是一项回顾性横断面研究，涉及中国14家医院的7个科室。计算ALB-dNLR评分，并在倾向得分匹配（PSM）后比较ALB-dNLR评分阳性和阴性组的结局。之后，在PSM后，比较使用全球营养不良领导倡议（GLIM）标准诊断的营养不良患者中接受营养支持和未接受营养支持的组之间的结局。
结果
在10184例病例中，6165例符合条件。2200例在ALB-dNLR评分阳性组。PSM后，分析了1458对，结果显示ALB-dNLR评分阴性组的住院死亡率较低（0.8%对2.1%，p = 0.005），医院感染率较低（5.9%对11.0%，p < 0.001）。在营养不良患者中，PSM后分析了259对。结果显示，支持组在死亡率（0.8%对3.5%，p = 0.033）、医院感染率（5.4%对15.4%，p < 0.001）、住院时间（LOS）（13.8±10.3对18.4±14.1，p < 0.001）和总住院费用（3315.3±2946.4对4795.3±4198.2，p < 0.001）方面有更好的结局。在以ALB-dNLR评分为唯一病因标准的营养不良患者中，计算了94对。结果显示，支持组在死亡率（0.0%对6.4%，p = 0.029）、医院感染率（7.4%对18.1%，p = 0.029）、LOS（13.7±8.3对19.8±15.
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