首页|重症监护病房老年重症肺炎患者肠内营养不耐受的风险预测模型

重症监护病房老年重症肺炎患者肠内营养不耐受的风险预测模型

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目的 分析重症监护病房(intensive care unit,ICU)老年重症肺炎(severe pneumonia,SP)患者肠内营养不耐受的危险因素并构建其预测模型.方法 选取2021年1月到2022年12月宁波大学附属第一医院ICU病房老年SP患者140例,根据肠内营养耐受情况分为耐受组(n=82)和不耐受组(n=58),采用单因素及多因素 Logistic回归分析ICU老年SP患者发生肠内营养不耐受的危险因素,构建风险预测模型,绘制受试者操作特征(receiver operating characteristic,ROC)曲线评估模型预测效果.结果 多因素 Logistic回归分析显示急性胃肠损伤分级(acute gastrointestinal injury,AGI)、腹内压(intra-abdominal pressure,IAP)、使用抗生素≥2 种是ICU老年SP患者肠内营养不耐受的独立影响因素(P<0.05).模型采用 Hosmer-Lemeshow 拟合优度检验评估方程拟合效果,曲线下面积为 0.867(95%CI:0.750~0.984),敏感度为87.8%,特异性为 85.1%.结论 本研究构建的风险预测模型可有效预测ICU老年SP患者肠内营养不耐受的发生风险.
Risk prediction model of enteral nutrition intolerance in elderly patients with severe pneumonia in intensive care unit
Objective To analyze the risk factors of enteral nutrition intolerance in elderly patients with severe pneumonia(SP)in intensive care unit(ICU)and construct its prediction model.Methods A total of 140 elderly patients with severe pneumonia in ICU ward of the First Affiliated Hospital of Ningbo University from January 2021 to December 2022 were selected.According to the tolerance of enteral nutrition,they were divided into tolerance group(n=82)and intolerance group(n=58).Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of enteral nutrition intolerance in elderly patients with severe pneumonia in ICU.The risk prediction model was constructed,and the receiver operating characteristic(ROC)curve was drawn to evaluate the prediction effect of the model.Results Multivariate Logistic regression analysis showed that acute gastrointestinal injury(AGI),intra-abdominal pressure(IAP),and the use of antibiotics≥2 were independent influencing factors of enteral nutrition intolerance in elderly patients with severe pneumonia in ICU(P<0.05).The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the fitting effect of the equation.The area under the curve was 0.867(95%CI:0.750-0.984),the sensitivity was 87.8%,and the specificity was 85.1%.Conclusion The risk prediction model constructed in this study can effectively predict the risk of enteral nutrition intolerance in elderly patients with severe pneumonia in ICU.

Severe pneumonia in the elderlyEnteral nutrition intoleranceRisk factorsPrediction model

魏维维、赵娜、孙泽桑、邵亚娣

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宁波大学附属第一医院重症医学科,浙江宁波 315010

老年重症肺炎 肠内营养不耐受 危险因素 预测模型

浙江省医药卫生科技计划

2023KY1049

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(11)
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