诺莫格拉姆可以预测重症儿童的食不耐症
Ying Lin1, Xiaomin Wang2, Lingyan Li3
1Department of Nutrition, Tianjin Children's Hospital /Tianjin University Children's Hospital, 225 Longyan Rd, Beichen Dist, Tianjin, China. yinglin@alu.scu.edu.cn.
重症儿童的食不耐受性是由较高的PIM3分数,机械通风,败血症和低血预测的,较高的白蛋白水平是保护性的. 这有助于识别有风险的儿童,以获得更好的结果.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 胃肠病学 胃肠病学
- 临床预测建模临床预测建模
背景情况:
- 料不耐受性 (FI) 与重症患者的预后不佳有关.
- 胃肠道功能障碍是多器官功能障碍综合征 (MODS) 的关键组成部分和发起者.
- 之前的研究表明,FI与重症患者群体的不良结果之间存在显著的关联.
研究的目的:
- 在重症儿童中表征料不耐受 (FI).
- 在这个脆弱的患者群体中确定FI的预测因子.
- 开发和验证儿童重症监护中的FI预测模型.
主要方法:
- 从2017年1月到2022年6月,对854名儿童在儿科重症监护室 (PICU) 的回顾性队列研究.
- 对18个潜在因素的分析,包括临床评分,干预措施和实验室值,以预测FI.
- 开发使用多变量逻辑回归的预测名录,并通过内部验证和决策曲线分析进行验证.
主要成果:
- 在854名儿童 (25.2%) 中,有215名儿童出现了料不耐受症 (FI).
- 确定了六个重要的预测因素:儿童死亡率指数3 (PIM3) 评分,机械通风 (MV),败血症,低血,白蛋白和动脉部分氧气压 (PaO2).
- 较高的PIM3分数,MV,败血症,低血和较低的PaO2是独立的危险因素;较高的白蛋白是保护因素. 诺米图表显示出强大的预测值 (C指数为0.940).
结论:
- 一个经过验证的诺姆图有效地预测了重症儿童的料不耐受性 (FI).
- 关键预测因素包括PIM3分数,MV,败血症,低血,白蛋白和PaO2.
- 该名图表显示出良好的临床适用性和预测性能,有助于早期识别和管理FI.
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