Predictive value of mNUTRIC score for chronic critical illness in elderly patients with sepsis
10.3760/cma.j.issn.1671-0282.2022.01.014
- VernacularTitle:mNUTRIC评分对老年脓毒症患者发生慢重症的预测价值
- Author:
Lingling WANG
1
;
Rui CHEN
;
Jiahui DONG
;
Chengwei LEI
;
Richeng XIONG
;
Zhenhui GUO
Author Information
1. 南部战区总医院重症医学科内科病区，广州市老年感染与脏器功能支持重点实验室，国家老年疾病临床医学研究中心（解放军总医院）广东分中心，广州 510010
- Keywords:
mNUTRIC;
Ederly;
Sepsis;
Chronic critical illness
- From:
Chinese Journal of Emergency Medicine
2022;31(1):73-77
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of the modified NUTrition risk in the critically ill (mNUTRIC) score for chronic critical illness (CCI) in elderly sepsis patients.Methods:A prospective observational study was conducted. Elderly sepsis patients admitted to Medical Intensive Care Unit (MICU) of General Hospital of Southern Theatre Command for more than 24 h from August 2019 to January 2021 were enrolled. Age, sex, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, acute gastrointestinal injury (AGI) score, clinical frailty score and mNUTRIC score at admission, length of ICU stay, usage of mechanical ventilation and renal replacement therapy were recorded. According to the occurrence of CCI, patients were divided into the CCI group and rapid recovery (RAP) group, and the differences between the two groups were compared. The risk factor of CCI after sepsis in elderly patients were analyzed by log-binomial regression analysis. Receiver operating characteristic (ROC) analysis was performed for mNUTRIC score. Differences were considered significant at P<0.05. Results:Of the enrolled 91 sepsis patients, 14 (15%) patients died within the first week, 37 (41%) exhibited RAP and 40 (44%) developed CCI. The CCI patients were significantly older and presented a higher APACHE Ⅱ score, CFS score, mNUTRIC score, and usage of mechanical ventilation and renal replacement therapy compared with the RAP patients ( P<0.05). Multivariate regression analysis revealed that mNUTRIC score was an independent risk factor for the development of CCI in elderly sepsis patients, prevalence ratio was 1.503 (95% CI: 1.007-2.244). The area under the curve (AUC) of mNUTRIC score was 0.706 (95% CI: 0.592-0.805). Conclusions:The mNUTRIC score at the time of admission in the intensive care unit can be used to predict CCI after sepsis in elderly sepsis patients.
