迷你营养评估简表联合国家早期预警评分对脓毒症急性呼吸窘迫综合征患者预后的影响

目的 探讨迷你营养评估简表(mini nutritional assessment short-form,MNA-SF)联合国家早期预警评分(national early warning score,NEWS)对脓毒症急性呼吸窘迫综合征预后的影响.方法 选取南京中医药大学附属南京市中西医结合医院2017年1月至2021...

Prognostic value of mini nutritional assessment short-form combined with national early warning score in pa-tients with septic acute respiratory distress syndrome

Objective To explore the effect of mini nutritional assessment short-form(MNA-SF)combined with national early warning score(NEWS)on the prognosis of sepsis acute respiratory distress syndrome(ARDS).Methods 150 patients with septic ARDS treated in Nanjing integrated traditional Chinese and western medicine Hospital Affiliated with Nanjing University of Chinese Medicine from January 2017 to January 2021 were selected as the research objects.After admission,the vital signs,general clinical data,basic diseases,body mass index(BMI),ventilator parameters,mechanical ventilation time,ICU stay time,blood biochemistry,blood gas analysis procalcitonin(PCT),andthe maximum dose of noradrenaline(NE)was recorded.The scores of MNA-SF and NEWS were performed,and the mortality of patients was followed up for 28 days.According to the 28-day survival of the patients,they were divided into 91 cases in the survival group and 59 cases in the death group.The PCT,CRP,PH value,lactic acid,plateau pressure(Pplat),positive end-expiratory pressure(PEEP),mechanical ventilation time,ICU stay time,and MNA-SF and NEWS score differenceswere compared between the two groups.A binary logistic regression model and the area under the ROC curve were used to evaluate the predictive value of MNA-SF and NEWS scores and their combined scores on the prognosis of patients with septic ARDS.The correlation between MNA-SF,NEWS score,and the prognosis indexes of patients with respiratory failure,including lactic acid,plateau pressure,mechanical ventilation time were analyzed.Results MNA-SF,NEWS,and combined scores had higher values for the prognosis of patients(AUC=0.796,0.799,0.860,respectively),and the value of combined scores was higher than that of a single scoring system(combined score vs.MNA-SF,Z=4.568>1.96,P<0.001;combined score vs.NEWS,Z=4.447>1.96,P<0.001,the sensitivity and specificity of predicting the risk of death were 89.6%and 81.1%,respectively).In addition,the MNA-SF score was negativelycorrelated withthe patient's lactate,plateau pressure,and mechanical ventilation time(r=-0.38,-0.30,-0.33,all P<0.01),while the NEWS score had a good positive correlation(r=0.36,0.42,0.38,P<0.001).Conclusion Both MNA-SF and NEWS scores have higher predictive value for the prognosis of patients with septic ARDS,and the combination is better than the single score.