{"title":"计算机断层扫描隔膜厚度用于危重新冠肺炎患者的营养评估和住院预测。","authors":"Yong You, Ming Chen, Xiancheng Chen, Wenkui Yu","doi":"10.6133/apjcn.202203_31(1).0004","DOIUrl":null,"url":null,"abstract":"BACKGROUND AND OBJECTIVES\nTo evaluate the significance of diaphragm thickness (DT) in assessing the nutritional status and predicting the length of hospital stay (LOS) of patients with COVID-19.\n\n\nMETHODS AND STUDY DESIGN\nThe data of 212 patients with severe and critical COVID-19 in Wuhan, China, were retrospectively analyzed. Computed tomography (CT)-obtained DT was measured in cross-sectional images of the mediastinal window at the level of the outlet of the celiac trunk at admission and at 2 weeks, then the rate of change in DT(RCDT) at 2 weeks was calculated. Nutritional risk and malnutrition were evaluated at admission.\n\n\nRESULTS\nA total of 91 patients were involved in the study. The mean DT was 3.06±0.58 mm (3.15±0.63 mm in male and 2.93±0.50 mm in female). DT was significantly negatively correlated with malnutrition based on Global Leadership Initiative on Malnutrition (GLIM) criteria (r=-0.324, p=0.002), Nutritional Risk Screening 2002 (NRS-2002) score (r=-0.364, p=0.000) and the Malnutrition Universal Screening Tool (MUST) score (r=-0.326, p=0.002) at admission. For the prediction of LOS ≥4 weeks in patients with COVID-19, the area under the ROC curve (AUC) of the RCDT at 2 weeks was 0.772, while the AUCs of DT, NRS-2002, MUST and Nutrition Risk in Critically Ill scores at admission were 0.751, 0.676, 0.638 and 0.699 respectively. According to the model of multiple linear regression analysis, the DT at admission (β=-0.377, p=0.000), RCDT at 2 weeks (β =-0.323, p=0.001), and mechanical ventilation (β=0.192, p=0.031) were independent risk factors contributed to LOS.\n\n\nCONCLUSIONS\nCT-obtained DT can be used as a dynamic assessment tool for evaluating the nutritional status of patients in isolation wards for COVID-19.","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"5","resultStr":"{\"title\":\"Diaphragm thickness on computed tomography for nutritional assessment and hospital stay prediction in critical COVID-19.\",\"authors\":\"Yong You, Ming Chen, Xiancheng Chen, Wenkui Yu\",\"doi\":\"10.6133/apjcn.202203_31(1).0004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND AND OBJECTIVES\\nTo evaluate the significance of diaphragm thickness (DT) in assessing the nutritional status and predicting the length of hospital stay (LOS) of patients with COVID-19.\\n\\n\\nMETHODS AND STUDY DESIGN\\nThe data of 212 patients with severe and critical COVID-19 in Wuhan, China, were retrospectively analyzed. Computed tomography (CT)-obtained DT was measured in cross-sectional images of the mediastinal window at the level of the outlet of the celiac trunk at admission and at 2 weeks, then the rate of change in DT(RCDT) at 2 weeks was calculated. Nutritional risk and malnutrition were evaluated at admission.\\n\\n\\nRESULTS\\nA total of 91 patients were involved in the study. The mean DT was 3.06±0.58 mm (3.15±0.63 mm in male and 2.93±0.50 mm in female). DT was significantly negatively correlated with malnutrition based on Global Leadership Initiative on Malnutrition (GLIM) criteria (r=-0.324, p=0.002), Nutritional Risk Screening 2002 (NRS-2002) score (r=-0.364, p=0.000) and the Malnutrition Universal Screening Tool (MUST) score (r=-0.326, p=0.002) at admission. For the prediction of LOS ≥4 weeks in patients with COVID-19, the area under the ROC curve (AUC) of the RCDT at 2 weeks was 0.772, while the AUCs of DT, NRS-2002, MUST and Nutrition Risk in Critically Ill scores at admission were 0.751, 0.676, 0.638 and 0.699 respectively. According to the model of multiple linear regression analysis, the DT at admission (β=-0.377, p=0.000), RCDT at 2 weeks (β =-0.323, p=0.001), and mechanical ventilation (β=0.192, p=0.031) were independent risk factors contributed to LOS.\\n\\n\\nCONCLUSIONS\\nCT-obtained DT can be used as a dynamic assessment tool for evaluating the nutritional status of patients in isolation wards for COVID-19.\",\"PeriodicalId\":8486,\"journal\":{\"name\":\"Asia Pacific journal of clinical nutrition\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2022-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asia Pacific journal of clinical nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.6133/apjcn.202203_31(1).0004\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Pacific journal of clinical nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.6133/apjcn.202203_31(1).0004","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Diaphragm thickness on computed tomography for nutritional assessment and hospital stay prediction in critical COVID-19.
BACKGROUND AND OBJECTIVES
To evaluate the significance of diaphragm thickness (DT) in assessing the nutritional status and predicting the length of hospital stay (LOS) of patients with COVID-19.
METHODS AND STUDY DESIGN
The data of 212 patients with severe and critical COVID-19 in Wuhan, China, were retrospectively analyzed. Computed tomography (CT)-obtained DT was measured in cross-sectional images of the mediastinal window at the level of the outlet of the celiac trunk at admission and at 2 weeks, then the rate of change in DT(RCDT) at 2 weeks was calculated. Nutritional risk and malnutrition were evaluated at admission.
RESULTS
A total of 91 patients were involved in the study. The mean DT was 3.06±0.58 mm (3.15±0.63 mm in male and 2.93±0.50 mm in female). DT was significantly negatively correlated with malnutrition based on Global Leadership Initiative on Malnutrition (GLIM) criteria (r=-0.324, p=0.002), Nutritional Risk Screening 2002 (NRS-2002) score (r=-0.364, p=0.000) and the Malnutrition Universal Screening Tool (MUST) score (r=-0.326, p=0.002) at admission. For the prediction of LOS ≥4 weeks in patients with COVID-19, the area under the ROC curve (AUC) of the RCDT at 2 weeks was 0.772, while the AUCs of DT, NRS-2002, MUST and Nutrition Risk in Critically Ill scores at admission were 0.751, 0.676, 0.638 and 0.699 respectively. According to the model of multiple linear regression analysis, the DT at admission (β=-0.377, p=0.000), RCDT at 2 weeks (β =-0.323, p=0.001), and mechanical ventilation (β=0.192, p=0.031) were independent risk factors contributed to LOS.
CONCLUSIONS
CT-obtained DT can be used as a dynamic assessment tool for evaluating the nutritional status of patients in isolation wards for COVID-19.
期刊介绍:
The aims of the Asia Pacific Journal of Clinical Nutrition
(APJCN) are to publish high quality clinical nutrition relevant research findings which can build the capacity of
clinical nutritionists in the region and enhance the practice of human nutrition and related disciplines for health
promotion and disease prevention. APJCN will publish
original research reports, reviews, short communications
and case reports. News, book reviews and other items will
also be included. The acceptance criteria for all papers are
the quality and originality of the research and its significance to our readership. Except where otherwise stated,
manuscripts are peer-reviewed by at least two anonymous
reviewers and the Editor. The Editorial Board reserves the
right to refuse any material for publication and advises
that authors should retain copies of submitted manuscripts
and correspondence as material cannot be returned. Final
acceptance or rejection rests with the Editorial Board