Construction and validation of a risk prediction model for enteral nutrition feeding intolerance in neurology intensive care unit patients

Objective To explore the related influencing factors of enteral nutrition feeding intolerance(ENFI) in neurology intensive care unit patients, and establish a nomogram of ENFI.

Methods From January 2022 to November 2024, 109 neurology intensive care unit patients were selected as the research subjects.Data collection was conducted continuously for 5 days using the general information questionnaire and ENFI questionnaire.Multivariate analysis was performed using the binary logistic regression equation, and a nomogram prediction model was constructed.The receiver operating characteristic(ROC) curve was used to evaluate the efficacy of the prediction model.

Results ENFI occurred in 40 cases(36.70%) of patients.The differences in the Glasgow coma scale (GCS) score, combination with or without diabetes, blood K⁺ level, serum albumin level, having mechanical ventilation or not, using drugs or not and nutritional risk were statistically significant between the ENFI group and tolerance group(P < 0.05).The results of logistic regression analysis showed that the coexisting diabetes, use of vasoactive drugs and use of mechanical ventilation were the independent risk factors of ENFI in neurology intensive care unit patients.The use of proton pump inhibitors(PPIs), GCS score of ≥5 points, and serum albumin level ≥35 g/L were the protective factors.The AUC(95%CI) of the nomogram model was 0.870(0.798-0.942), the sensitivity was 75.0%, and the specificity was 91.3%.The model predicted a good potential clinical effects.

Conclusions Diabetes mellitus and use of vasoactive drugs and mechanical ventilation are the independent risk factors of ENFI in neurology intensive care unit patients, while the use of PPIs, GCS score ≥5 points and serum albumin ≥35 g/L are the protective factors.In clinical nursing work, the occurrence of ENFI in neurology intensive care unit patients can be predicted by paying attention to the above factors, and the relevant measures can be taken to prevent nutritional risks, and improve the prognosis of patients.