预后营养指数与患有呼吸机相关肺炎的重症患者全因死亡率之间的关联:基于MIMIC- IV数据库的回顾性研究
Wenwen Ji1, Guangdong Wang1, Jia Liu2
1Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Frontiers in nutrition
|September 3, 2025
概括
较高的预后营养指数 (PNI) 与呼吸器相关性肺炎 (VAP) 患者的死亡率较低有关. 早期的PNI评估可以确定高风险的VAP患者进行有针对性的干预.
科学领域:
- 危急护理医学
- 营养生物标志物
- 传染性疾病
背景情况:
- 呼吸器相关的肺炎 (VAP) 是高死亡率的重症监护室的一个关键挑战.
- 预后营养指数 (PNI) 反映了营养和免疫状况,在VAP中预后价值不明.
- 本研究研究了PNI与VAP患者死亡率之间的关联.
研究的目的:
- 评估预后营养指数 (PNI) 的预后意义.
- 确定PNI水平与VAP患者30天和90天全因死亡率之间的关联.
- 通过先进的统计分析来探索PNI和死亡率之间的关系.
主要方法:
- 来自MIMIC- IV数据库的1457名VAP患者的回顾性分析.
- 根据PNI四分位数和最佳值分类的患者.
- 进行了考克斯回归,限制立方脊柱 (RCS) 分析和小组分析.
主要成果:
- 整体30天和90天死亡率分别为23. 68%和34. 32%.
- 较高的PNI四分位数与显著降低的死亡风险有关 (调整后HR< 1).
- RCS分析显示PNI与死亡率之间存在"L"形的非线性关系 (p < 0. 001).
结论:
- 在ICU入院时,较高的PNI独立地与VAP患者的短期和长期死亡率较低有关.
- 常规PNI评估可以帮助早期识别高风险的VAP患者.
- PNI可以指导有针对性的营养和免疫干预措施以改善VAP结果.
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