摘要
目的·验证改良危重症营养风险(modified Nutrition Risk in the Critically Ill,mNUTRIC)评分在老年危重症患者营养风险评估及预测其临床预后中的作用。方法·使用mNUTRIC评分评估2020年10月—2021年2月入住上海交通大学附属第一人民医院综合重症监护室(intensive care unit,ICU)的老年患者,根据评估结果将患者分为高营养风险组和低营养风险组。对2组患者进行观察记录至转科、出院或死亡,分析不同营养风险患者的营养支持情况(包括营养支持方式、支持开始时间及能量供给达标情况),比较不同营养风险患者的ICU停留时间、机械通气时间和28 d病死率。结果·老年危重症患者中,高营养风险者占51.8%。2组患者的营养支持方式差异无统计学意义。低营养风险组的能量达标率为73.3%,高营养风险组的能量达标率为58.8%,差异无统计学意义。低营养风险组能量达标所用时间为5.00 (1.00,8.00) d,高营养风险组能量达标所用时间为9.00 (3.00,12.50) d,差异无统计学意义。高营养风险组的机械通气时间为5.00 (1.50,12.50) d,长于低营养风险组(P=0.018);高营养风险组28 d病死率47.7%,高于低营养风险组(P=0.001)。2组患者的ICU停留时间差异无统计学意义。结论·在老年危重症患者中可以使用mNUTRIC评分来进行营养风险的评估,评估结果可用于预测老年危重症患者的临床预后。建议根据评估结果对于不同营养风险的老年危重症患者进行临床分层营养管理,通过个性化的营养支持方案等方式,使得老年危重症患者从营养支持中获益,并可能改善患者的临床预后。
Objective·To validate the role of the modified Nutrition Risk in the Critically Ill(mNUTRIC) score in the assessment of nutritional risk and clinical prognosis in critically ill elderly patients. Methods·A prospective observational study was carried out. The mNUTRIC score was employed to assess the nutritional risk of elderly patients who were admitted into the intensive care unit(ICU) of Shanghai General Hospital, Shanghai Jiao Tong University between October 2020 and February 2021. Patients were divided into high nutritional risk group and low nutritional risk group based on the mNUTRIC score results. The observational endpoints were transferred, discharged or death. Different nutrition risk patients’ nutritional support were analyzed, including nutritional support methods, the time period before nutritional support, and energy supply conditions. The length of ICU stay, days with mechanical ventilation, and 28-day mortality of different nutrition risk patients were compared. Results·Among critically ill elderly patients, 51.8% were at high nutritional risk. The energy compliance rate of the low nutritional risk group was 73.3%, and that of the high nutritional risk group was 58.8%. It took 5.00(1.00, 8.00) d for the low nutritional risk group and 9.00(3.00, 12.50) d for the high nutritional risk group to reach the energy standard. There was no statistical difference in the nutritional support methods, the time period before nutritional support, and energy supply conditions between the two groups. The mechanical ventilation time of the high nutritional risk group was 5.00(1.50, 12.50) d, longer than that of the low nutritional risk group(P=0.018). The 28-day mortality rate of the high nutritional risk group was 47.7%, higher than that of the low nutritional risk group(P=0.001). There was no statistical difference in ICU stay between the two groups. Conclusion·mNUTRIC score can be used to evaluate nutritional risk and predict the clinical prognosis of critically ill elderly patients. It is suggested that st
作者
陆雪梅
陈兰
LU Xuemei;CHEN Lan(School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China;Department of Nursing,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 200080,China)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2022年第1期16-20,共5页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海市卫生健康委员会项目(201940074)。
关键词
重症监护
老年人
营养评价
预后
营养支持
critical care
aged
nutrition assessment
prognosis
nutritional support
