Analysis of Influencing Factors of Occurrence Nutritional Risk in Patients with AECOPD Combined with Type Ⅱ Respiratory Failure and Construction of Prediction Model
Objective:To explore the influencing factors of occurrence nutritional risk in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with type Ⅱ respiratory failure,and to construct a prediction model.Methods:177 patients with AECOPD combined with type Ⅱ respiratory failure admitted to the Inner Mongolia Autonomous Region People's Hos-pital from January 2021 to December 2022 were retrospectively selected,patients were divided into nutritional risk group(122 cases)and non-nutritional risk group(55 cases)according to the Nutritional Risk Screening 2002(NRS2002)score.The influencing factors of oc-currence nutritional risk in patients with AECOPD combined with type Ⅱ respiratory failure who were analyzed by univariate and multi-variate Logistic regression,and prediction model was constructed according to the regression model.The predictive performance of the prediction model was verified by receiver operating characteristic(ROC)curve.Results:Univariate analysis showed that the age in nutri-tional risk group was older than that in non-nutritional risk group(P＜0.05),the course of COPD was longer than that in non-nutritional risk group(P＜0.05),chronic gastric disease,number of acute exacerbations ≥ 3 times/year,and the modified British Medical Research Council Dyspnea Questionnaire(mMRC)score of grade 3-4 was higher than that in non-nutritional risk group(P＜0.05),the forced expi-ratory volume in the first second(FEV1),FEV1/forced vital capacity(FVC),body mass index(BMI),albumin,prealbumin,grip strength,and oxygen partial pressure(PO2)were lower than those in non-nutritional risk group(P＜0.05),the neutrophil count/lymphocyte count ratio(NLR),chronic obstructive pulmonary disease assessment test questionnaire(CAT)score,acute physiology and chronic health eval-uation Ⅱ(APACHE Ⅱ)score were higher than those in non-nutritional risk group(P＜0.05).Multivariate Logistic regression analysis showed that advanced age,high mMRC score,chronic gastric disease,and high NLR were risk factors for occurrence nutritional risk in patients with AECOPD combined with type Ⅱ respiratory failure(P＜0.05),and high FEV1/FVC was protective factor(P＜0.05).The area under the curve based on the regression model to predict the nutritional risk of patients AECOPD combined with type Ⅱ respiratory fail-ure was 0.820,and the sensitivity and specificity were 81.97％and 83.64％respectively,the Hosmer-Lemeshow test P＞0.05,and the model fitting effect was good.Conclusion:Advanced age,high mMRC score,chronic gastric disease and high NLR are risk factors for occurrence nutritional risk in patients with AECOPD combine with type Ⅱ respiratory failure,and high FEV1/FVC is protective factor.Predicting the nutritional risk of patients AECOPD combine with type Ⅱ respiratory failure base on regression models has high value.
Acute exacerbation of chronic obstructive pulmonary diseaseType Ⅱ respiratory failureNutritional riskInfluencing factorsPrediction model
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