肺结核住院病人营养不良风险预测模型构建

    Construction of the malnutrition risk prediction model for pulmonary tuberculosis inpatients

    • 摘要:
      目的: 探讨肺结核住院病人营养不良影响因素,构建营养不良的风险预测模型。
      方法: 采用便利抽样方法选取住院治疗的肺结核病人322例为研究对象。依据NRS 2002营养风险筛查评分,将病人分为无风险组238例和有风险组84例。分析肺结核住院病人营养不良的影响因素,并构建营养不良风险预测模型,采用ROC曲线分析验证模型预测效果。
      结果: 322例病人营养不良发生率为26.09%(84/322)。2组病人年龄、运动情况、是否初治、体质量指数(BMI)、小腿围、临床症状(咳痰、胸闷气喘、发热、纳差)、病灶累及肺叶数和血红蛋白、前白蛋白(PA)、淋巴细胞百分比差异均有统计学意义(P < 0.05 ~ P < 0.01)。小腿围、PA、运动情况、BMI均为肺结核住院病人营养不良的独立影响因素(P < 0.05 ~ P < 0.01)。ROC曲线分析显示,肺结核住院病人营养不良预测模型AUC为0.948,灵敏度和特异度分别为93.2%、82.67%。
      结论: 肺结核住院病人营养不良风险发生率相对较高,临床需重视BMI < 18.5 kg/m2和运动较少病人,并重视监测病人小腿围,关注短期内PA降低幅度较大病人,据此构建风险预测模型对肺结核住院病人营养不良有较好预测价值。

       

      Abstract:
      Objective To investigate the influencing factors of malnutrition in inpatients with pulmonary tuberculosis and construct a risk prediction model of malnutrition.
      Methods A total of 322 pulmonary tuberculosis patients were selected by convenience sampling method, and divided into the non-risk group (238 cas) and risk group (84 cases) according to the NRS 2002 nutritional risk screening score. The influencing factors of malnutrition in hospitalized patients with pulmonary tuberculosis were analyzed, and a malnutrition risk prediction model was constructed. The prediction effect of model was verified by ROC curve analysis.
      Results The incidence of malnutrition was 26.09% (84/322) in 322 patients. There were statistically significant in the age, exercise status, initial treatment, BMI, leg circumference, clinical symptoms (sputum, chest tightness, asthma, fever and poor appetite), number of lung lobes involved in the lesion and laboratory indicators (Hemoglobin, prealbumin and lymphocyte percentage) between the two groups (P < 0.05 to P < 0.01). The Calf circumference, PA, exercise status and BMI were the independent influencing factors of malnutrition in hospitalized patients with pulmonary tuberculosis (P < 0.05 to P < 0.01). The results of ROC curve analysis showed that the AUC of the malnutrition prediction model for inpatients with pulmonary tuberculosis was 0.948, and the sensitivity and specificity were 93.2% and 82.67%, respectively.
      Conclusions The incidence of malnutrition risk in hospitalized patients with pulmonary tuberculosis is relatively high. Clinically, patients with BMI < 18.5 kg/m2 and less exercise should be paid attention to, the calf circumference of patients should be monitored, and the .patients with a large decrease in PA in the short termshould also be paid attention to. Based on this, the construction of a risk prediction model has a good predictive value for malnutrition in hospitalized patients with pulmonary tuberculosis.

       

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