Construction of a malnutrition risk prediction model for patients with stroke and dysphagia
10.3760/cma.j.cn341190-20240308-00234
- VernacularTitle:脑卒中吞咽障碍患者营养不良风险预测模型的构建
- Author:
Jingjing YANG
1
;
Jingwen JIAN
;
Lingying CHEN
;
Juanjuan HU
Author Information
1. 温州市中心医院神经内科，温州 325000
- Keywords:
Cerebrovascular disorders;
Deglutition disorders;
Malnutrition;
Risk factors;
Factor analysis, statistical;
Nomograms;
Forecasting
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(10):1484-1489
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the current status of malnutrition and its influential factors among patients with stroke and dysphagia, and to develop and validate a malnutrition risk prediction model.Methods:Using a convenience sampling method, 150 patients with stroke and dysphagia admitted to Wenzhou Central Hospital from January 2019 to December 2023 were included in this study. Through a review of the literature and expert consultations, 15 influential factors were identified: age, gender, body mass index (BMI), history of smoking alcohol consumption , number of hospitalizations, education level, Barthel index, history of hypertension, history of diabetes, coronary heart disease, presence of limb disabilities, hemoglobin levels, Glasgow Coma Scale (GCS) score, and National Institutes of Health Stroke Scale score. Patients were categorized into malnutrition and normal groups based on the occurrence of malnutrition. The influential factors for malnutrition were analyzed, and a malnutrition risk prediction model was constructed using regression analysis. The model was presented using a nomogram and subsequently validated.Results:Among the 150 patients with stroke and dysphagia, the average age was (59.34 ± 6.46) years, with 83 females and 67 males. Of these patients, 66 (44.00%) were found to be malnourished. The following factors were identified as independent risk factors for malnutrition in patients with stroke and dysphagia: age (χ2 = 4.03, P = 0.045), BMI ( t = 6.33, P < 0.001), alcohol consumption (χ2 = 3.90, P = 0.048), number of hospitalizations (χ2 = 9.45, P = 0.024), Barthel index (χ2 = 7.78, P = 0.020), presence of limb disabilities (χ2 = 4.64, P = 0.031), hemoglobin levels (χ2 = 4.38, P = 0.036), and GCS score (χ2 = 9.83, P = 0.007) (all P < 0.05). Patients who were older, had a BMI < 18.5 kg/m2, consumed alcohol, had more than five hospitalizations, a Barthel index < 40, limb disabilities, abnormal hemoglobin levels, or a GCS score ≤ 11 were more likely to experience malnutrition (all P < 0.05). The C-index for predicting malnutrition was 0.851, with a 95% CI of (0.809, 0.892). The maximum Youden index was 0.562, with a sensitivity of 84.1% and specificity of 72.1%. Conclusion:The risk factors for malnutrition in patients with stroke and dysphagia include advanced age, alcohol consumption, more than five hospitalizations, limb disabilities, and abnormal hemoglobin levels. Protective factors against malnutrition in these patients are a BMI > 23.9 kg/m2, a Barthel index > 60, and a GCS score ≥ 14. The prediction model demonstrates a significant predictive value for the occurrence of malnutrition in patients with stroke and dysphagia.
