Construction of a risk prediction model for refeeding syndrome in patients with acute pancreatitis and its nursing implications
10.3761/j.issn.0254-1769.2024.13.011
- VernacularTitle:急性胰腺炎患者再喂养综合征风险预测模型的构建及护理启示
- Author:
Hongmei HE
1
;
Fang YU
;
Lihua LIN
;
Fang SHU
Author Information
1. 341000 江西省赣州市人民医院消化内科
- Keywords:
Acute Pancreatitis;
Refeeding Syndrome;
Risk Factors;
Risk Prediction Model;
Nursing Care
- From:
Chinese Journal of Nursing
2024;59(13):1608-1615
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors affecting the occurrence of refeeding syndrome in patients with acute pancreatitis,to establish a risk prediction model and verify it,and provide enlightenment for clinical nursing management.Methods A total of 260 patients with acute pancreatitis in our hospital from January 2021 to March 2023 were selected and divided into a refeeding syndrome group and a non-refeeding syndrome group according to whether refeeding syndrome occurred.Logistic regression analysis was performed on the related factors,and the risk model of array diagram was constructed and verified.Results Of the 260 patients with acute pancreatitis,56 developed refeeding syndrome,with an incidence of 21.54%.The results of factor analysis showed that high grade of gastrointestinal function,additional protein supplementation during feeding,NRS score and rapid infusion of nutrient solution were independent risk factors for refeeding syndrome in patients with acute pancreatitis(OR>1,P<0.05).High serum prealbumin concentration before feeding and high serum albumin concentration before feeding were independent protective factors(OR<1,P<0.05).The results of Hosmer-Lemeshow goodness-of-fit test showed that χ2=8.019,P=0.432;the area under the ROC curve was 0.915(P<0.001,95%CI:0.865～0.965);the sensitivity was 83.30%;the specificity was 87.90%;the maximum Youden index was 0.712.The model regression equation Logit(P)=1.899×additional protein supplementation in feeding+1.549×gastrointestinal function classification+0.683×NRS score+0.031×nutrient solution infusion rate-0.018×prefeeding serum albumin-0.038×prefeeding serum albumin-9.836.Conclusion The risk prediction model of refeeding syndrome in patients with acute pancreatitis established in this study has good accuracy and discrimination,which can predict the risk of refeeding syndrome in patients with acute pancreatitis for clinical nursing staff and formulate individualized prevention strategies as soon as possible.
