The effect of nutritional risk and Acute Physiology and Chronic Health EvaluationⅡ on the prognosis of critically ill patients
10.3760/cma.j.issn.1672-7088.2016.13.001
- VernacularTitle:营养风险及急性生理学与慢性健康状况评分与危重症患者预后的关系
- Author:
Xiuchuan LI
- Publication Type:Journal Article
- Keywords:
Prognosis;
Critically illness;
Nutritional risk;
Acute Physiology and Chronic Health EvaluationⅡ;
Nutrition index
- From:
Chinese Journal of Practical Nursing
2016;32(13):961-964
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of nutritional risk and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ) on the prognosis of critically ill patients. Methods From January 2014 to November 2015, 138 critically ill patients were screened using Nutritional Risk Screening 2002 (NRS-2002) in intensive care unit (ICU) of our hospital. APACHEⅡand nutritional status of the patients were measured at the same time. Patients were divided into the survival group and death group according to the prognosis,the NRS-2002, nutritional status and APACHEⅡscores were compared between the two groups.The effect of NRS-2002 and APACHEⅡon the prognosis of critically ill patients was analyzed. Results Of 138 critically ill patients, 131 cases were found nutritional risk and 82 patients survived (62.60%) ,7 cases were found without nutritional risk and 5 patients survived,There were no significant differences in survival rate of both groups(P=0.714). The APACHEⅡscores in the nutritional risk group were (22.14 ± 6.86) points, which were obviously higher than those of non-nutritional risk group(5.80 ± 1.90)points. There were significant differences(t′=17.47,P<0.01). The RBC, HGB and ALB of patients in the death group were(3.18±0.31)×1012/L,(104.00±12.83)g/L and(28.54±3.83)g/L,respectively, which were significantly lower than those of the survival group, that were(3.52±0.53)×1012/L,(118.00±16.32)g/L and(31.44±4.81)g/L ,respectively. There were significant differences(t/t′=3.67-4.75,P<0.01). The CRP of patients in the death group were(88.59 ± 19.24)mg/L,which were obviously higher than those of the survival group(44.36±17.88)mg/L. There were significant differences(t=13.67,P<0.01), while there were no significant differences for TLC in two groups(P>0.05).Logistic regression analysis showed APACHEⅡ, nutritional risks, RBC,HGB,ALB and CRP were all the risk factors for the prognosis of critically ill patients(P<0.01), while APACHEⅡ, RBC, nutritional risks and ALB were the leading influencing factors. Conclusions There exists higher nutritional risks among the critically ill patients. APACHEⅡ, RBC, nutritional risks and ALB should be given more attention when they are admitted in the ICU. Patients′nutritional status should be comprehensively evaluated and the prognosis of the patients should be predicted.
