开发和评估一个风险预测模型的肠道营养在重症监护病房的食不耐受性
Xiaohua Cao1, Hua Wang2, Yinling Song1
1Department of Intensive Care Medicine, Jining No. 1 People's Hospital, Jining, China.
Frontiers in nutrition
|October 6, 2025
概括
一种新的诺莫格拉姆模型有效地预测了重症患者的肠道营养食不耐症 (ENFI). 该工具有助于评估ENFI风险,改善接受肠道营养 (EN) 的重症监护病房 (ICU) 患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 临床营养学 临床营养学
- 预测建模预测建模
背景情况:
- 肠道营养 (EN) 对重症病患在重症监护室 (ICU) 的患者至关重要.
- 食不耐受 (FI) 是EN的常见并发症,可能会使患者的预后恶化.
- 早期识别和管理ENFI对于最佳的患者结果至关重要.
研究的目的:
- 在重症病房ICU患者中识别肠道营养食不耐症 (ENFI) 的风险因素.
- 开发和验证用于评估ENFI风险的预测模型.
- 改善EN在重症监护机构的管理.
主要方法:
- 在144名ICU患者的数据上使用二进制后勤回归开发了一个预测模型.
- 变量选择包括单变量分析和多对线性测试.
- 构建了一个名图,并使用AUC,灵敏度,特异性,PPV,NPV和Hosmer-Lemeshow测试来评估模型性能. 内部验证是使用bootstrapping.执行的.
主要成果:
- 开发了一种包含APACHE II分数,机械通风,白蛋白,腹内压力和EN开始时间的诺莫图.
- 该模型的AUC为0.800,具有良好的灵敏度 (82.5%) 和特异性 (72.4%).
- 内部验证证实了良好的校准和预测准确性,Hosmer-Lemeshow测试没有显著性 (p=0.9346).
结论:
- 开发的诺米图表显示了ENFI在重症监护病房患者中的强大预测性能.
- 该模型是临床医生评估和管理ENFI风险的宝贵工具.
- 有效的风险评估可以改善治疗策略和重症监护患者的治疗结果.
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