营养支持对不同营养风险的重症患者死亡率的影响:通过元分析进行系统审查
Lingling Bao1, Youquan Wang1, Yuting Li1
1Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China.
Frontiers in nutrition
|December 4, 2025
概括
患有高营养风险的重症患者面临死亡率增加. 充足的能源支持可能会降低这一群体的死亡率,但RCT的证据是不确定的.
科学领域:
- 临界护理医学 临界护理医学
- 营养科学 营养科学
- 基于证据的医学基于证据的医学.
背景情况:
- 确定最佳的营养支持对于重症患者至关重要.
- 营养风险分层有助于定制干预措施.
- 修改后的重症患者营养风险评分 (mNUTRIC) 将患者分为高 (5-9) 和低 (0-4) 风险组.
研究的目的:
- 根据其营养风险,为重症患者确定有效的营养支持策略.
- 评估营养支持对不同风险群体死亡率的影响.
主要方法:
- 随机对照试验 (RCT) 和观察性研究的系统审查和元分析.
- 在2025年5月19日之前搜索了PubMed,MEDLINE,Cochrane图书馆和Embase.
- 包括11项试验,包括7442名参与者,按mNUTRIC得分分层.
主要成果:
- 高营养风险与增加的死亡率有显著关联 (OR: 2.26).
- 充足的能量摄入与高风险患者28天死亡率的降低相关 (OR:0.60).
- 然而,在高风险患者中,随着足够的能量支持,RCT没有显示出28天或90天死亡率的显著降低.
结论:
- mNUTRIC评分是严峻病情患者预后的验证工具.
- 它在指导特定能源支持建议中的实用性需要进一步研究.
- 目前的证据表明,充足的能量摄入对高风险患者有潜在的益处,但需要更强大的RCT数据.
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