Correlation Study of Nutritional Status, Mental Health, Sleep Quality, and Prognosis in Patients with Acute Myeloid Leukemia: Construction of Early Warning Combined with Mindfulness Awareness Countermeasures.

Abstract

Objective: To explore the correlation between nutritional status, mental health, sleep quality and prognosis of Acute Myeloid Leukemia (AML) patients, and implement the combined countermeasures of early - warning and mindfulness - based interventions.

Methods: A total of 141 AML patients admitted to our hospital between January 2020 and April 2023 were enrolled as research subjects. Based on the follow-up outcomes, the patients were categorized into a poor - prognosis group (n=32) and a good-prognosis group (n=109). The general demographic data, clinical data, Prognostic nutritional index (PNI), Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score and Pittsburgh Sleep Quality Index (PSQI) were collected for analysis. Pearson correlation analysis was performed to assess the associations between nutritional status, psychological state, sleep quality, and prognosis, and multivariate Logistic regression analysis was used to analyze the difference indicators. Based on this, a nomogram was constructed, and the calibration curve and decision curves were plotted for internal validation of model discrimination and calibration.

Results: A statistically significant difference was observed in the scores of the Self - Rating Anxiety Scale (SAS), Self - Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), and Prognostic Nutritional Index (PNI) between the two patient groups (P<0.05). These indices were positively correlated with the prognosis of AML patients (P<0.05). Upon Logistic regression analysis, the SAS, SDS, PSQI scores, and PNI were all identified as independent risk factors for poor prognosis in patients, with OR > 1, indicating increased risk of poor prognosis. A prognostic prediction model incorporating these four predictors was established using Logistic regression. In the defined threshold range, the net benefit of the prediction model was relatively high, suggesting that the model exhibited good accuracy in predicting the prognosis of AML patients.

Conclusion: The SAS, SDS, PSQI scores, and PNI were significantly associated with the prognosis of AML patients and served as independent predictors. The prognostic prediction model constructed based on these factors could effectively identify high-risk groups. This provides a potential framework for the clinical implementation of the combined countermeasures of early-warning and mindfulness - based interventions.