在MIMIC-IV数据库中的重症中风患者中,肠道营养时间和28天死亡率之间的关系
Xiaoliang Wang1, Xiuling Xie1, Xin Xu2
1Neurology Department of Qingdao Municipal Hospital, Nanjing Medical University, Qingdao, Shandong, China.
Frontiers in neurology
|August 21, 2024
概括
危急性中风患者的早期肠道营养 (EN) 可能会增加28天死亡风险. 需要进行进一步的研究,以确定最佳的EN时间,以便在重症监护室 (ICU) 设置中获得更好的结果.
科学领域:
- 关键护理医学 关键护理医学
- 神经学 神经学
- 营养支持 营养支持
背景情况:
- 在重症中风患者中,肠道营养 (EN) 的时间受到争议.
- 早期EN (EEN) 启动对结果的影响尚不清楚.
- 这项研究调查了中风患者的EN时间和28天死亡率.
研究的目的:
- 检查EN启动时间和28天死亡率之间的关联.
- 分析早期与晚期脑内科在重症中风患者中的影响.
- 为优化神经临床护理中的营养策略提供证据.
主要方法:
- 使用MIMIC-IV数据库进行回顾性队列研究.
- 包括在住院期间接受EN的中风患者.
- 使用了考克斯回归和受限立方线 (RCS) 分析.
主要成果:
- 包括997名患者;31.9%的人经历了28天的死亡率.
- 未经调整的分析显示了EN时间和死亡率之间的相关性 (p=0.044).
- 多变量分析表明,早期的EN启动与28天死亡率的增加有关 (调整后OR=1.27,p=0.048).
结论:
- 在重症中风患者中早期启动EN可能与较高的28天死亡率有关.
- 对EN启动的最佳时机需要进一步调查.
- 研究结果表明,在神经临床护理中需要个性化营养方法.
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