改良NUTRIC评分与体外循环心脏术后患者预后的关系  

Relationship between modified NUTRIC score and prognosis of patients after cardiopulmonary bypass sur⁃gery

作　　者：许晶 徐望 江欣怡 李莹 邓佳 方恒 陈纯波 XU Jing;XU wang;JIANG Xinyi;LI Ying;DENG Jia;FANG Heng;CHEN Chunbo(The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510515,China;Department of Critical Care Medi-cine,Guangdong Provincial People′s Hospital,Guangzhou 510080,China;不详)

机构地区：[1]南方医科大学第二临床医学院,广州510515 [2]广东省人民医院重症医学科,广州510080 [3]南方医科大学附属茂名医院,广东茂名525099

出　　处：《实用医学杂志》2023年第8期963-968,共6页The Journal of Practical Medicine

基　　金：广东省人民医院登峰计划项目(编号:DFJH2020028);茂名市引进创新创业团队项目(编号:茂人才办[2020]24)。

摘　　要：目的 探讨改良危重症营养风险(modified nutrition risk in the critically ill,mNUTRIC)评分对体外循环心脏术后患者预后的预测价值。方法 收集2020年6月至2022年8月南方医科大学附属茂名医院重症监护病房(intensive care unit,ICU)诊治的252例体外循环心脏术后患者的临床资料,根据入ICU24 h内mNUTRIC评分结果分为高营养风险组和低营养风险组。通过二元logistic回归方法分析影响患者预后的危险因素;ROC曲线评估mNUTRIC评分对体外循环心脏术后患者院内病死率的预测作用。结果 高营养风险组肾脏替代治疗比例、机械通气时间、ICU住院时间以及院内病死率均高于低营养风险组,差异均有统计学意义(P <0.05)。多因素分析显示mNUTRIC评分为体外循环心脏术后患者预后的独立影响因素(P <0.05)。mNUTRIC评分预测院内病死率的曲线下面积为0.824,其预测的敏感度和特异度分别为65.0%、89.6%。结论 mNUTRIC评分对体外循环心脏术后患者院内病死率有良好的预测能力,有望作为心脏术后评估指标应用于临床。Objective To investigate the predictive value of modified nutrition risk in the critically ill(mNUTRIC)score in patients after cardiopulmonary bypass.Methods Clinical data of 252 patients after cardiopulmonary bypass surgery were collected from June 2020 to August 2022 in the intensive care unit(ICU)of Maoming Hospital Affiliated to Southern Medical University.Patients were divided into high and low nutritional risk groups based on modified NUTRIC score within 24 hours of ICU admission.Binary logistic regression analysis was used to evaluate the risk factors affecting the prognosis of patients.The receiver operating characteristic(ROC)curve was used to evaluate the performance of modified NUTRIC score on hospital mortality in patients after cardiopulmonary bypass surgery.Results The rate of renal replacement therapy,duration of mechanical ventila⁃tion,length of ICU stay and hospital mortality in the high nutritional risk group were higher than those in the low nutritional risk group(P<0.05).Multivariate analysis showed that mNUTRIC score was an independent risk factor for the prognosis of patients after cardiopulmonary bypass(P<0.05).The area under the curve predicted by the mNUTRIC score was 0.824,with a sensitivity and specificity of 65.0%and 89.6%,respectively.Conclusions mNUTRIC score is a good predictor of hospital mortality in patients after cardiopulmonary bypass surgery and is expected to be used in clinical application as an evaluation index after cardiac surgery.

关 键 词：mNUTRIC评分 体外循环 心脏手术 预后评估 院内病死率 

分 类 号：R654.2[医药卫生—外科学]