医学新知2024，Vol.34Issue(8)：888-896,9.DOI:10.12173/j.issn.1004-5511.202405016
长期卧床老年患者营养不良危险因素及风险预测模型构建
Risk factors and prediction model construction for malnutrition in long-term bedridden elderly patients
摘要
Abstract
Objective To explore the risk factors for malnutrition(MN)in elderly patients with long-term bed and to construct a risk prediction model for MN.Methods Elderly patients with long-term bed admitted to the Department of Geriatrics of the Fourth People's Hospital of Yaan from January 2016 to January 2024 were retrospectively selected,and their clinical data were collected.The elderly patients with long-term bed were randomly divided into training set and validation set,according to the ratio of 7∶3.The patients were divided into MN group and non-MN group according to whether MN occurred.In the training set,the differences in clinical data between the groups were compared by univariate analysis(t-test,chi-square test or Fisher's exact test),and the risk factors for MN in patients were analyzed by stepwise multivariate Logistic regression,and a risk prediction model was constructed.The predictive efficiency of the risk prediction model was evaluated and verified by the receiver operating characteristic curve(ROC)and ROC area under curve(AUC),calibration curve and decision curve.Results A total of 896 elderly patients with long-term bed were included,and the incidence of MN was 46.43％.There were 627 cases in the training set and 269 cases in the validation set.Multivariate Logistic regression analysis showed that long bed rest time[OR=1.259,95％CI(1.197,1.324)],stroke[OR=2.866,95％CI(1.621,5.067)],and anemia[OR=2.479,95％CI(1.162,5.288)]were risk factors for MN in elderly patients with long-term bed,and high Barthel index score[OR=0.921,95％CI(0.905,0.938)]was a protective factor(P＜0.05).The MN risk prediction model had high predictive efficiency,with AUC(95％CI)of 0.955(0.939,0.970)and 0.952(0.934,0.971)in the training set and validation set,respectively.In the training set and the validation set,the calibration curve showed that the"predicted MN probability"and"actual MN probability"of the MN risk prediction model were highly consistent;the decision curve showed that the MN risk prediction model could bring clinical benefits within a certain risk threshold range.Conclusion In clinical practice,elderly patients with long-term bed who are bedridden for a long time,have stroke or anemia,and have poor daily living ability should be pay more atlentron for the MN risk.The MN risk prediction model constructed in this study can provide a certain reference for identifying the high-risk MN population in elderly patients with long-term bed.关键词
长期卧床/营养不良/脑卒中/贫血/Barthel指数/危险因素/预测模型Key words
Long-term bed/Malnutrition/Stroke/Anemia/Barthel index/Risk factors/Predictive model引用本文复制引用
张仟威,杨潇,杨雪梅..长期卧床老年患者营养不良危险因素及风险预测模型构建[J].医学新知,2024,34(8):888-896,9.基金项目
雅安市重点科技计划项目(2019yyjskf09) （2019yyjskf09）
