摘要
目的比较微型营养评定法简表(MNA-SF)评分、血液指标和人体测量指标对老年脑卒中相关性肺炎(SAP)的预测价值。方法选取2021年11月至2022年5月于南昌大学第一附属医院治疗并确诊为脑卒中的317例老年患者。收集患者一般资料、疾病史、MNA-SF评分、血液指标和人体测量指标。结局指标为是否发生SAP。构建多因素Logistic回归模型分析MNA-SF评分与SAP的关系。绘制森林图比较各营养指标和SAP风险的关联性。采用受试者工作特征曲线(ROC)评估各营养指标对SAP的预测性能。结果317例脑卒中患者中86例(27.13%)发生SAP。在校正一般资料、疾病史、血液指标和人体测量指标等协变量后,多因素Logistic回归分析显示营养不良风险(MNA-SF评分8~11分)是预测SAP发生的独立危险因素OR=4.72(95%CI:1.61~13.85)。ROC曲线分析显示预测SAP的MNA-SF评分最佳截断值为11.00,曲线下面积为0.837(95%CI:0.792~0.876),显著优于其他指标如球蛋白、血红蛋白和胸围等(P<0.05)。结论MNA-SF评分与SAP发生风险相关。与其他营养指标相比,MNA-SF评分对SAP预测价值更高。入院时对老年脑卒中患者进行MNA-SF评分有助于对SAP高危患者的早期识别。
Objective To comparatively evaluate the predictive value of Mini Nutritional Assessment Short-Form(MNA-SF)score,blood biomarkers,and anthropometric parameters for stroke-associated pneumonia(SAP)in elderly populations.Methods A cohort of 317 elderly patients diagnosed with stroke and treated at the First Affiliated Hospital of Nanchang University between November 2021 and May 2022 was enrolled.Demographic characteristics,medical history,MNA-SF scores,blood biomarkers,and anthropometric parameters were systematically collected.The primary outcome was the occurrence of SAP.Multivariable logistic regression models were constructed to analyze the association between MNA-SF scores and SAP incidence.Forest plots were generated to visualize comparative associations between nutritional indicators and SAP risk.Predictive performance of individual nutritional parameters for SAP was evaluated using receiver operating characteristic(ROC)curve analysis.Results Among 317 stroke patients,86 cases(27.13%)developed SAP.Multivariable logistic regression analysis demonstrated that nutritional risk(MNA-SF score 8-11 points)emerged as an independent risk predictor for SAP development after adjusting for covariates including demographic characteristics,medical history,hematological parameters,and anthropometric measures(OR=4.72,95%CI:1.61-13.85).ROC curve analysis identified an optimal MNA-SF cutoff value of 11.00 for SAP prediction,yielding an area under the curve(AUC)of 0.837(95%CI:0.792-0.876).This predictive performance demonstrated statistically superior discriminatory power compared to other indicators including globulin,hemoglobin,and chest circumference(P<0.05).Conclusion The MNA-SF score may be associated with SAP risk in elderly stroke patients.Compared to conventional nutritional parameters,the MNA-SF demonstrates superior predictive validity for SAP.Implementing MNA-SF screening at hospital admission may facilitate early identification of high-risk populations for SAP prevention.
作者
廖雄
朱祥
李远志
廖爱红
LIAO Xiong;ZHU Xiang;LI Yuan-zhi;LIAO Ai-hong(Department of Nutrition,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China;Jiangxi Provincial Key Laboratory of Preventive Medicine,School of Public Health,Nanchang University,Nanchang 330006,China;Department of Nursing,the First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,China)
基金
江西省教育厅科学技术研究项目(GJJ210149)
江西省卫健委科技计划(202210393)。
关键词
脑卒中相关性肺炎
微型营养评定法简表
营养评价
预测
老年人
stroke-associated pneumonia
Mini Nutritional Assessment Short-Form
nutritional evaluation
prediction
elderly patient
