65 岁以上住院恶性肿瘤患者营养不良风险预测模型的构建与验证:一项单中心回顾性横断面研究。

IF 2.3 3区 生物学 Q2 MULTIDISCIPLINARY SCIENCES PeerJ Pub Date : 2024-12-10 eCollection Date: 2024-01-01 DOI:10.7717/peerj.18685
Xuexing Wang, Jie Chu, Chunmei Wei, Jinsong Xu, Yuan He, Chunmei Chen
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Construction and validation of a predictive model for the risk of malnutrition in hospitalized patients over 65 years of age with malignant tumours: a single-centre retrospective cross-sectional study.

Background: Nutritional status is a critical indicator of overall health in individuals suffering from malignant tumours, reflecting the complex interplay of various contributing factors. This research focused on identifying and analysing the factors influencing malnutrition among older patients aged ≥65 with malignant tumours and aimed to develop a comprehensive risk model for predicting malnutrition.

Methods: This study conducted a retrospective analysis of clinical data from 3,387 older inpatients aged ≥65 years with malignant tumours collected at our hospital from July 1, 2021, to December 31, 2023. The dataset was subsequently divided into training and validation sets at an 8:2 ratio. The nutritional status of these patients was evaluated using the Nutritional Risk Screening Tool 2002 (NRS-2002) and the 2018 Global Leadership Initiative on Malnutrition (GLIM) Standards for Clinical Nutrition and Metabolism. Based on these assessments, patients were categorized into either malnutrition or non-malnutrition groups. Subsequently, a risk prediction model was developed and presented through a nomogram for practical application.

Results: The analysis encompassed 2,715 individuals in the development cohort and 672 in the validation cohort, with a malnutrition prevalence of 40.42%. A significant positive correlation between the incidence of malnutrition and age was observed. Independent risk factors identified included systemic factors, tumour staging (TNM stage), age, Karnofsky Performance Status (KPS) score, history of alcohol consumption, co-infections, presence of ascites or pleural effusion, haemoglobin (HGB) levels, creatinine (Cr), and the neutrophil-to-lymphocyte ratio (NLR). The predictive model exhibited areas under the curve (AUC) of 0.793 (95% confidence interval (CI) [0.776-0.810]) for the development cohort and 0.832 (95% CI [0.801-0.863]) for the validation cohort. Calibration curves indicated Brier scores of 0.186 and 0.190, while the Hosmer-Lemeshow test yielded chi-square values of 5.633 and 2.875, respectively (P > 0.05). Decision curve analysis (DCA) demonstrated the model's clinical applicability and superiority over the NRS-2002, highlighting its potential for valuable clinical application.

Conclusion: This study successfully devised a straightforward and efficient prediction model for malnutrition among older patients aged 65 and above with malignant tumours. The model represents a significant advancement as a clinical tool for identifying individuals at high risk of malnutrition, enabling early intervention with targeted nutritional support and improving patient outcomes.

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来源期刊
PeerJ
PeerJ MULTIDISCIPLINARY SCIENCES-
CiteScore
4.70
自引率
3.70%
发文量
1665
审稿时长
10 weeks
期刊介绍: PeerJ is an open access peer-reviewed scientific journal covering research in the biological and medical sciences. At PeerJ, authors take out a lifetime publication plan (for as little as $99) which allows them to publish articles in the journal for free, forever. PeerJ has 5 Nobel Prize Winners on the Board; they have won several industry and media awards; and they are widely recognized as being one of the most interesting recent developments in academic publishing.
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