Nutrition-related risk factors for pulmonary infection in patients with severe stroke
10.3760/cma.j.cn211501-20200925-04011
- VernacularTitle:重症脑卒中患者肺部感染与营养相关的危险因素分析
- Author:
Ruixin ZHANG
1
;
Feng LI
;
Lihong HUANG
;
Guangwei LIU
Author Information
1. 重庆医科大学附属第一医院神经内科 400016
- Keywords:
Neuro-intensive care unit;
Severe stroke;
Pulmonary infection;
Nutritional status;
Risk factor
- From:
Chinese Journal of Practical Nursing
2021;37(34):2644-2649
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of nutritional status on pulmonary infection in patients with severe stroke, and to identify the nutrition-related risk factors of pulmonary infection, so as to provide reference for the prevention and treatment of pulmonary infection from the perspective of nutrition.Methods:The clinical data of 122 patients admitted to the neuro-intensive care unit (NICU) of the First Affiliated Hospital of Chongqing Medical University from August 2019 to February 2020 were retrospectively analyzed. Patients with severe stroke were divided into two groups according to whether they had pulmonary infection during hospitalization in NICU, and there were 25 patients in case group and 97 patients in control group. Nutritional Risk Screening (NRS2002), Nutrition Risk in the Critically ill (NUTRIC) score and malnutrition criteria, combined with anthropometry, clinical comprehensively history and laboratory data were used to evaluate the nutritional status of patients. Logistic regression was used to identify nutrition-related risk factors for pulmonary infection in patients with severe stroke.Results:The incidence of pulmonary infection in severe stroke patients was 20.5% (25/122). Univariate analysis showed that the difference of chronic obstructive pulmonary disease, endotracheal intubation, nasogastric tube use, NUTRIC ≥ 5, the Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, Sequential Organ Failure Assessment (SOFA), Glasgow Coma Scale (GCS), and creatinine levels, duration of enteral nutrition, length NICU stay, and length of hospital stay between the two groups were statistically significant ( χ2 value was 7.542-34.403, t value was 2.207, Z value was -3.511, 3.083 and 3.115, P<0.05 or 0.01). Multivariate Logistic regression analysis showed that NUTRIC≥5 ( OR= 12.202, 95% CI 2.342-63.568) and nasogastric tube use ( OR=16.990, 95% CI5.343-54.024) were independent risk factors of pulmonary infection in patients with severe stroke ( P<0.01). Conclusions:NUTRIC score≥ 5, high nutritional risk and nasogastric tube use were independent risk factors of pulmonary infection in patients with severe stroke, which should be given early nutritional assessment and individualized care.