2023 年第 11 期 第 18 卷

病程早期迷你营养评估简表评分与脓毒症患者预后的关系

Correlation of mini nutrition assessment short form score with prognosis in patients with sepsis in the early stage

作者：韩雪1王喜福2李凤杰1李多3

英文作者：Han Xue1 Wang Xifu2 Li Fengjie1 Li Duo3

单位：1首都医科大学附属北京潞河医院急诊科，北京100049；2首都医科大学附属北京安贞医院急诊危重症中心，北京100029；3首都医科大学附属北京潞河医院重症医学科，北京100049

英文单位：1Department of Emergency Beijing Luhe Hospital Capital Medical University Beijing 100049 China; 2Department of Emergency and Critical Care Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 3Department of Intensive Care Medicine Beijing Luhe Hospital Capital Medical University Beijing 100049 China

关键词：脓毒症；迷你营养评估简表；预后

英文关键词：Sepsis;Mininutritionassessmentshortform;Prognosis

• 摘要：

• 目的  探讨病程早期迷你营养评估简表（MNA-SF）评分与脓毒症患者预后的关系。方法  选取2022年1月1日—12月31日首都医科大学附属北京潞河医院急诊危重症中心收治的142例脓毒症患者为研究对象，根据住院28 d全因死亡情况将患者分为存活组和死亡组。比较2组基线资料、临床数据、MNA-SF评分、序贯器官衰竭评估（SOFA）评分、快速SOFA（qSOFA）评分、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分。采集患者抗菌药物使用时间、住院时间及住院费用。分析脓毒症患者住院28 d全因死亡的影响因素；绘制受试者工作特征（ROC）曲线分析MNA-SF、SOFA、APACHEⅡ评分对脓毒症患者预后的预测价值。结果  住院期间共40例患者死亡（死亡组），其余102例患者存活（存活组）。死亡组MNA-SF评分、白蛋白水平、体重指数、淋巴细胞计数、抗菌药物使用时间、住院时间均低于/短于存活组，qSOFA评分、SOFA评分、APACHEⅡ评分、住院费用均高于存活组（均P＜0.05）。多因素Logistic回归分析结果显示，MNA-SF评分、SOFA评分、APACHEⅡ评分是脓毒症患者住院28 d全因死亡的独立影响因素（均P＜0.05）。ROC曲线分析结果显示，MNA-SF评分预测脓毒症患者住院28 d全因死亡曲线下面积（AUC）为0.875（95%置信区间:0.802~0.947），SOFA评分的AUC为0.888（95%置信区间:0.831~0.944），APACHEⅡ评分的AUC为0.870（95%置信区间:0.804~0.935）。结论  MNA-SF评分是脓毒症患者住院28 d全因死亡的独立影响因素，且对其具有较高的预测价值。

• Objective  To explore the correlation of mini nutrition assessment short form (MNA-SF) score with prognosis in patients with sepsis in the early stage. Methods  Totally 142 patients with sepsis admitted to Department of Emergency and Critical Care Center, Beijing Luhe Hospital, Capital Medical University, from January 1, 2022 to December 31, 2022 were enrolled. They were divided into death group and survival group according to all-cause death with 28 d in hospital. Baseline data, clinical data, MNA-SF score, sequential organ failure assessment (SOFA) score, quick SOFA (qSOFA) score, and acute physiological and chronic health evaluation Ⅱ(APACHEⅡ) score were compared between the two groups. The antibiotic use time, total hospital stay and total hospital expenses of patients were recorded. Influencing factors of 28 d death in hospital in sepsis patients were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of scores of MNA-SF, SOFA and APACHEⅡ in prognosis in sepsis patients. Results  During hospitalization, there were 40 cases of death (death group) and other 102 cases were survival (survival group). Compared to the survival group, MNA-SF score, albumin, body mass index, lymphocyte count, length of antimicrobial use, length of hospital stay in the death group were lower/shorter, and qSOFA score, APACHEⅡ score, and total hospital expenses in the death group were higher (all P<0.05). Multivariate Logistic regression analysis showed that MNA-SF, SOFA and APACHEⅡ scores were independent influencing factors of 28 d all-cause death in hospital in sepsis patients (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of MNA-SF score in predicting sepsis patients 28 d all-cause death was 0.875 (95% confidence interval: 0.802-0.947), AUC of SOFA was 0.888 (95% confidence interval: 0.831-0.944), and AUC of APACHEⅡ was 0.870（95% confidence interval:0.804-0.935）. Conclusion  MNA-SF score is an independent influencing factor of 28 d all-cause death in sepsis patients, and it has high predictive value.