Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Niao Sung District, No. 123 Ta Pei Road, Kaohsiung, 83301, Taiwan.
Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan.
BMC Pulm Med. 2024 Sep 27;24(1):470. doi: 10.1186/s12890-024-03302-4.
This study aimed to investigate the impact of body composition variables on hospital mortality compared to other predictive factors among patients with severe pneumonia. Additionally, we aimed to monitor the dynamic changes in body composition variables over the course on days 1, 3, and 8 after intensive care unit (ICU) admission for each patient.
We conducted a prospective study, enrolling patients with severe pneumonia admitted to the medical intensive care unit at Kaohsiung Chang Gung Memorial Hospital from February 2020 to April 2022. We collected clinical data from all patients and assessed their body composition at 1, 3, and 8 days post-ICU admission. On day 1, we analyzed clinical and body composition variables to predict in-hospital mortality.
Multivariate analysis identified the Modified Nutrition Risk in the Critically Ill (mNUTRIC) score and the ratio of total body water to fat-free mass (TBW/FFM) as independent factors associated with in-hospital mortality in severe pneumonia patients. Receiver operating characteristic analysis determined that the TBW/FFM ratio was the most reliable predictive parameter of in-hospital mortality, with a cutoff value of 0.74. General linear regression with repeated measures analysis showed that hospital non-survivors displayed notable fluctuations in body water, fat, and muscle variables over the course of days 1, 3, and 8 after ICU admission.
The mNUTRIC score and TBW/FFM ratio emerged as independent factors for predicting hospital mortality, with the TBW/FFM ratio demonstrating the highest reliability as a predictive parameter.
本研究旨在探讨与其他预测因素相比，身体成分变量对重症肺炎患者住院死亡率的影响。此外，我们旨在监测每位患者入住重症监护病房（ICU）后第 1、3 和 8 天身体成分变量的动态变化。
我们进行了一项前瞻性研究，纳入 2020 年 2 月至 2022 年 4 月期间入住高雄长庚纪念医院内科重症监护病房的重症肺炎患者。我们从所有患者中收集临床数据，并在入住 ICU 后第 1、3 和 8 天评估他们的身体成分。在第 1 天，我们分析临床和身体成分变量以预测住院死亡率。
多变量分析确定改良营养风险在危重病患者（mNUTRIC）评分和总身体水分与去脂体重（TBW/FFM）的比例是与重症肺炎患者住院死亡率相关的独立因素。受试者工作特征分析确定 TBW/FFM 比值是住院死亡率的最可靠预测参数，截断值为 0.74。具有重复测量分析的一般线性回归显示，住院幸存者在入住 ICU 后第 1、3 和 8 天的身体水分、脂肪和肌肉变量出现明显波动。
mNUTRIC 评分和 TBW/FFM 比值是预测住院死亡率的独立因素，TBW/FFM 比值作为预测参数具有最高的可靠性。
