摘要
目的:探讨两种营养风险筛查工具对神经系统危重症患者发生ICU获得性衰弱(ICU-AW)的预测价值,并对合并营养风险的神经系统危重症患者发生ICU-AW的危险因素进行分析。方法:收集2022年1—12月在ICU住院的240例神经系统危重症患者的临床资料。使用NRS-2002评分及mNUTRIC两种工具对患者是否发生ICU-AW进行诊断性试验。观察MRC-Score评分、GCS、SOFA、APACHEⅡ、机械通气等指标,对患者发生ICU-AW的影响因素进行分析。结果:最终纳入240例患者,ICU-AW发生率51.67%。mNUTRIC评分及NRS-2002评分灵敏度分别为64.50%、36.30%,特异度分别是65.50%、75.00%,假阳性率分别是36.68%、47.58%,假阴性率分别是33.35%、39.18%。单因素分析显示,MRC-Score评分、mNUTRIC评分、APACHEⅡ评分、SOFA评分、GCS评分、机械通气为ICU-AW的影响因素(P<0.05),多元线性回归分析显示,mNUTRIC评分、GCS评分为患者发生ICU-AW的独立影响因素(P<0.05)。结论:神经系统危重症患者ICU-AW发病率较高,mNUTRIC评分、APACHEⅡ评分、SOFA评分、GCS评分以及机械通气与患者发生ICU-AW存在影响。mNUTRIC评分相较NRS-2002评分在诊断营养高风险患者ICU-AW具有较好的预测价值。
Objective:To explore the predictive value of two nutritional risk screening tools for ICU-acquired weakness(ICU-AW)in critically ill neurological patients,and to analyze the risk factors for ICU-AW in critically ill neurological patients with nutritional risk.Methods:The clinical data of 240 critically ill neurological patients hospitalized in the ICU from January 2022 to December 2022 were collected.NRS-2002 score and mNUTRIC were used to diagnose whether patients had ICU-AW.We evaluated the mNUTRIC score,NRS-2002 score,MRC-Score,GCS,SOFA,APACHEⅡ,and mechanical ventilation to identify factors influencing ICU-AW.Results:We observed an incidence rate of 51.67%of ICU-AW among patients.The sensitivity of mNUTRIC score and NRS-2002 score were 64.50%and 36.30%,the specificity was 65.50%and 75.00%,the false positive rates were 36.68%and 47.58%,and the false negative rates were 33.35%and 39.18%,respectively.Univariate analysis revealed that MRC-Score,mNUTRIC score,APACHEⅡscore,SOFA score,GCS score,and mechanical ventilation were significant factors determining ICU-AW(P<0.05).Multiple linear regression analysis showed that mNUTRIC score and GCS score were independent influencing factors for ICU-AW in patients(P<0.05).Conclusion:The incidence of ICU-AW in critically ill neurological patients was high,and MRC-Score,mNUTRIC score,APACHEⅡscore,SOFA score,GCS score,and mechanical ventilation had an impact on the occurrence of ICU-AW in patients.Compared with NRS-2002,the mNUTRIC score has better predictive value in diagnosing ICU-AW in patients with high-risk nutrition.
作者
赵秋芬
周兴婷
谢霖
张志红
易先齐
邓静
ZHAO Qiufen;ZHOU Xingting;XIE Lin(Hubei Province Gong’an County People’s Hospital,434300;不详)
出处
《医学理论与实践》
2024年第24期4154-4157,共4页
The Journal of Medical Theory and Practice
基金
湖北省卫生健康委2023~2024年度面上项目基金(WJ2023M177)。
关键词
神经危重症
ICU获得性衰弱
营养风险
预测研究
影响因素
Neurocritical disease
ICU acquired weakness
Nutritional risk
Predictive research
Influencing factors
