在预后评分系统中加入老年营养风险指数并没有提高重症监护病房创伤患者的死亡率预测。

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
Cheng-Shyuan Rau, Ching-Hua Tsai, Sheng-En Chou, Wei-Ti Su, Shiun-Yuan Hsu, Ching-Hua Hsieh
{"title":"在预后评分系统中加入老年营养风险指数并没有提高重症监护病房创伤患者的死亡率预测。","authors":"Cheng-Shyuan Rau,&nbsp;Ching-Hua Tsai,&nbsp;Sheng-En Chou,&nbsp;Wei-Ti Su,&nbsp;Shiun-Yuan Hsu,&nbsp;Ching-Hua Hsieh","doi":"10.1155/2023/3768646","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is prevalent among critically ill patients and has been associated with a poor prognosis. This study sought to determine whether the addition of a nutritional indicator to the various variables of prognostic scoring models can improve the prediction of mortality among trauma patients in the intensive care unit (ICU).</p><p><strong>Methods: </strong>This study's cohort included 1,126 trauma patients hospitalized in the ICU between January 1, 2018, and December 31, 2021. Two nutritional indicators, the prognostic nutrition index (PNI), a calculation based on the serum albumin concentration and peripheral blood lymphocyte count, and the geriatric nutritional risk index (GNRI), a calculation based on the serum albumin concentration and the ratio of current body weight to ideal body weight, were examined for their association with the mortality outcome. The significant nutritional indicator was served as an additional variable in prognostic scoring models of the Trauma and Injury Severity Score (TRISS), the Acute Physiology and Chronic Health Evaluation (APACHE II), and the mortality prediction models (MPM II) at admission, 24, 48, and 72 h in the mortality outcome prediction. The predictive performance was determined by the area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>Multivariate logistic regression revealed that GNRI (OR, 0.97; 95% CI, 0.96-0.99; <i>p</i>=0.007), but not PNI (OR, 0.99; 95% CI, 0.97-1.02; <i>p</i>=0.518), was independent risk factor for mortality. However, none of these predictive scoring models showed a significant improvement in prediction when the GNRI variable is incorporated.</p><p><strong>Conclusions: </strong>The addition of GNRI as a variable to the prognostic scoring models did not significantly enhance the performance of the predictors.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247323/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Addition of the Geriatric Nutritional Risk Index to the Prognostic Scoring Systems Did Not Improve Mortality Prediction in Trauma Patients in the Intensive Care Unit.\",\"authors\":\"Cheng-Shyuan Rau,&nbsp;Ching-Hua Tsai,&nbsp;Sheng-En Chou,&nbsp;Wei-Ti Su,&nbsp;Shiun-Yuan Hsu,&nbsp;Ching-Hua Hsieh\",\"doi\":\"10.1155/2023/3768646\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Malnutrition is prevalent among critically ill patients and has been associated with a poor prognosis. This study sought to determine whether the addition of a nutritional indicator to the various variables of prognostic scoring models can improve the prediction of mortality among trauma patients in the intensive care unit (ICU).</p><p><strong>Methods: </strong>This study's cohort included 1,126 trauma patients hospitalized in the ICU between January 1, 2018, and December 31, 2021. Two nutritional indicators, the prognostic nutrition index (PNI), a calculation based on the serum albumin concentration and peripheral blood lymphocyte count, and the geriatric nutritional risk index (GNRI), a calculation based on the serum albumin concentration and the ratio of current body weight to ideal body weight, were examined for their association with the mortality outcome. The significant nutritional indicator was served as an additional variable in prognostic scoring models of the Trauma and Injury Severity Score (TRISS), the Acute Physiology and Chronic Health Evaluation (APACHE II), and the mortality prediction models (MPM II) at admission, 24, 48, and 72 h in the mortality outcome prediction. The predictive performance was determined by the area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>Multivariate logistic regression revealed that GNRI (OR, 0.97; 95% CI, 0.96-0.99; <i>p</i>=0.007), but not PNI (OR, 0.99; 95% CI, 0.97-1.02; <i>p</i>=0.518), was independent risk factor for mortality. However, none of these predictive scoring models showed a significant improvement in prediction when the GNRI variable is incorporated.</p><p><strong>Conclusions: </strong>The addition of GNRI as a variable to the prognostic scoring models did not significantly enhance the performance of the predictors.</p>\",\"PeriodicalId\":11528,\"journal\":{\"name\":\"Emergency Medicine International\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247323/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Emergency Medicine International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/3768646\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emergency Medicine International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/3768646","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0

摘要

背景:营养不良在危重患者中普遍存在,并与预后不良有关。本研究旨在确定在预后评分模型的各种变量中加入营养指标是否可以提高对重症监护病房(ICU)创伤患者死亡率的预测。方法:本研究纳入了2018年1月1日至2021年12月31日期间在ICU住院的1126例创伤患者。研究了两项营养指标,即基于血清白蛋白浓度和外周血淋巴细胞计数计算的预后营养指数(PNI)和基于血清白蛋白浓度和当前体重与理想体重之比计算的老年营养风险指数(GNRI),以确定它们与死亡率结局的相关性。在创伤和损伤严重程度评分(TRISS)、急性生理和慢性健康评估(APACHE II)以及入院、24、48和72小时死亡率预测模型(MPM II)的预后评分模型中,重要营养指标作为附加变量。预测性能由受者工作特性曲线下的面积决定。结果:多因素logistic回归显示GNRI (OR, 0.97;95% ci, 0.96-0.99;p=0.007),但PNI没有(OR, 0.99;95% ci, 0.97-1.02;P =0.518),是死亡的独立危险因素。然而,当纳入GNRI变量时,这些预测评分模型都没有显示出显著的预测改善。结论:在预后评分模型中加入GNRI作为一个变量并没有显著提高预测器的性能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Addition of the Geriatric Nutritional Risk Index to the Prognostic Scoring Systems Did Not Improve Mortality Prediction in Trauma Patients in the Intensive Care Unit.

The Addition of the Geriatric Nutritional Risk Index to the Prognostic Scoring Systems Did Not Improve Mortality Prediction in Trauma Patients in the Intensive Care Unit.

The Addition of the Geriatric Nutritional Risk Index to the Prognostic Scoring Systems Did Not Improve Mortality Prediction in Trauma Patients in the Intensive Care Unit.

Background: Malnutrition is prevalent among critically ill patients and has been associated with a poor prognosis. This study sought to determine whether the addition of a nutritional indicator to the various variables of prognostic scoring models can improve the prediction of mortality among trauma patients in the intensive care unit (ICU).

Methods: This study's cohort included 1,126 trauma patients hospitalized in the ICU between January 1, 2018, and December 31, 2021. Two nutritional indicators, the prognostic nutrition index (PNI), a calculation based on the serum albumin concentration and peripheral blood lymphocyte count, and the geriatric nutritional risk index (GNRI), a calculation based on the serum albumin concentration and the ratio of current body weight to ideal body weight, were examined for their association with the mortality outcome. The significant nutritional indicator was served as an additional variable in prognostic scoring models of the Trauma and Injury Severity Score (TRISS), the Acute Physiology and Chronic Health Evaluation (APACHE II), and the mortality prediction models (MPM II) at admission, 24, 48, and 72 h in the mortality outcome prediction. The predictive performance was determined by the area under the receiver operating characteristic curve.

Results: Multivariate logistic regression revealed that GNRI (OR, 0.97; 95% CI, 0.96-0.99; p=0.007), but not PNI (OR, 0.99; 95% CI, 0.97-1.02; p=0.518), was independent risk factor for mortality. However, none of these predictive scoring models showed a significant improvement in prediction when the GNRI variable is incorporated.

Conclusions: The addition of GNRI as a variable to the prognostic scoring models did not significantly enhance the performance of the predictors.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Emergency Medicine International
Emergency Medicine International EMERGENCY MEDICINE-
CiteScore
0.10
自引率
0.00%
发文量
187
审稿时长
17 weeks
期刊介绍: Emergency Medicine International is a peer-reviewed, Open Access journal that provides a forum for doctors, nurses, paramedics and ambulance staff. The journal publishes original research articles, review articles, and clinical studies related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care, sports medicine, wound care, and toxicology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信