儿科重症监护室的营养查:基于电子医疗记录的电子医疗记录工具的评估
Julia Hilbrands1, Mary Beth Feuling1, Aniko Szabo2
1Clinical Nutrition, Children's Wisconsin, Milwaukee, WI 53226, USA.
Nutrients
|November 14, 2023
概括
威斯康星州儿童营养查工具 (CWNST) 显示,在儿科重症监护室 (PICU) 中的重症儿童中检测营养不良的灵敏度很高. 虽然有效,但需要改进,以提高其特异性,以便更好地临床应用.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 临床营养学 临床营养学
- 医疗保健信息学 医疗保健信息学
背景情况:
- 在儿科重症监护室 (PICU) 的重症儿童面临营养不良的高风险.
- 现有的儿科营养查工具在PICU设置中缺乏验证.
- 威斯康星州儿童营养查工具 (CWNST) 将儿科营养查工具 (PNST) 与电子医疗记录数据相结合.
研究的目的:
- 评估CWNST在诊断重症儿童潜在营养不良方面的表现.
- 在PICU群体中,比较CWNST与单独PNST的有效性.
主要方法:
- 2019年在威斯康星州儿童医院接受PICU治疗的250名患者的回顾性分析,其中至少有一名饮食师进行了营养评估.
- 包括查元素,诊断和营养状况数据.
- 将CWNST性能指标 (灵敏度,特异性,PPV,NPV) 与单独的PNST进行比较.
主要成果:
- 在检测营养不良时,CWNST表现出高灵敏度 (0.985) 但低特异性 (0.06).
- 营养不良的预测因素包括亲肠道营养,阳性PNST和异常的BMI-for-age/weight-for-length z-scores.
- 大多数患者 (97.2%) 使用CWNST.获得了积极的营养查结果.
结论:
- CWNST是预测PICU患者营养风险的敏感工具,可以通过电子病历进行整合.
- 需要进一步完善CWNST以提高其特异性并减少错误阳性.
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