非手术原因接受机械呼吸机支持的危重患者营养评分与28天死亡率的关系

Ö. Taşkın, Özgür Yılmaz
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摘要

目的:营养不良可能导致重症监护病人的发病率和死亡率增加。在本研究中,我们旨在探讨非手术原因使用机械呼吸机的危重患者营养评分与28天死亡率之间的关系。方法:选取有资料的非手术原因入住重症监护病房的91例患者,对其进行机械呼吸机随访。根据患者资料计算预后营养指数(PNI)、老年营养风险指数(GNRI)、营养风险指数(NRI)和控制营养状态(CONUT)评分。患者分为生存组和非生存组。结果:幸存者组的NRI、PNI和GNRI评分在统计学上显著升高。中性粒细胞淋巴细胞比率、LDH白蛋白比率、CONUT、APACHE和SAPS评分在非幸存者组中具有统计学意义较高。在营养评分的logistic回归分析中,发现CONUT是死亡率的独立危险因素(表5)。在ROC分析中,CONUT的AUC值为0.925。CONUT的临界值为7.5,敏感性为86.4%,特异性为87.0%。结论:CONUT营养评分可作为确定重症监护患者28天死亡率的独立评估工具,可方便地从常规参数中计算且不产生额外费用。
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Relationship between butritional scores and 28-day mortality in critical patients who received mechanical ventilator support for non-surgical reasons
Aims: Malnutrition may cause an increase in morbidity and mortality in intensive care patients. In this study, we aimed to investigate the relationship between nutritional scores and 28-day mortality in critically ill patients followed on a mechanical ventilator for non-surgical reasons. Methods: 91 patients admitted to the intensive care unit for non-surgical reasons, followed up on mechanical ventilators, and whose data were available were included. The prognostic nutrition index (PNI), geriatric nutrition risk index (GNRI), nutritional risk index (NRI), and controlling nutritional status (CONUT) score were calculated from the data of the patients. Patients were divided into two groups survival and non-survival. Results: NRI, PNI, and GNRI scores were statistically significantly higher in the Survivor group. Neutrophil lymphocyte ratio, LDH albumin ratio, CONUT, APACHE, and SAPS scores were statistically higher in the nonsurvivor group. In logistic regression analysis for nutritional scores, CONUT was found to be an independent risk factor for mortality (table 5). In the ROC analysis, the AUC value for CONUT was 0.925. The cut-off value for CONUT was 7.5, the sensitivity was 86.4%, and the specificity was 87.0%. Conclusion: The CONUT nutrition score, which can be easily calculated from routine parameters and does not cause extra costs, can be used as an independent evaluation tool in determining the 28-day mortality of intensive care patients.
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