| 摘要: |
| 目的探讨全面主观营养评定法（SGA）在重症患者中的应用及对预后的预测价值。方法纳入重症患者101例，排除住院时间＜3d、脑死亡或肿瘤晚期的患者12例，最终纳入89例。所有患者入组后采集相关指标，并在48h内完成SGA，通过分析SGA与传统营养指标及预后指标的关系来探讨SGA在ICU中的应用和对预后的预测价值。结果使用SGA评定的营养不良（以下简称营养不良）患者病死率是营养正常患者的2倍（P=0.015），矫正混杂因素后，存在营养不良患者的死亡风险是营养正常患者的3.8倍（OR=3.785，95%CI1.153~12.425，P=0.028）。存在营养不良的患者的白蛋白、前白蛋白、BMI、肱头肌波褶（TSF）、上臂肌围（AMC）等指标低于营养正常组（均P＜0.05），营养不良与白蛋白等传统营养指标有相关性。营养不良患者的ICU住院时间较营养正常患者长，但差异无统计学意义（P=0.243）。结论SGA评定的营养不良与较多传统的营养指标有较好的一致性，对ICU患者的预后有预测价值，在ICU中有一定的应用前景。 |
| 关键词: 营养不良 重症患者 全面主观营养评定法 营养评估 |
| DOI： |
| 分类号: |
| 基金项目:国家卫生计生委科学研究基金-浙江省医药卫生重大科技计划项目（WKL-ZJ-1601） |
|
| Predictive value of subjective global assessment of nutritional status for prognosis of critically ill patients |
|
SUN Yanming, GONG Shijin, LU Haiyan, HU Wei, ZHENG Xia
|
|
Hangzhou First People's Hospital
|
| Abstract: |
| Objective To evaluate the application of subjective global assessment (SGA) of nutritional status in predicting the prognosis of critically ill patients. Methods Eighty nine critically ill patients were included in the study. The relevant indicators were collected and the SGA of nutritional status of patients was completed within 48h after admission. The relationship of SGA with traditional nutritional indexes and prognostic indicators was analyzed. Results The mortality rate of malnutrition patients was 2-fold higher than that of non-malnutrition patients (P=0.015). After correction of confounding factors, the risk of death in malnutrition patients was 3.8 times higher than that in non-malnutrition patients (OR=3.785, 95% CI: 1.153-12.425, P=0.028). The levels of albumin, prealbumin, BMI, TSF and AMC in malnutrition patients were all lower than those in the normal group; and malnutrition was correlated with traditional nutritional indexes (P＜0.05). However there was no significant difference in length of ICU stay between patients with malnutrition and without malnutrition (P=0.243). Conclusion SGA has a good consistency with traditional nutritional indicators, and has a predictive value for prognosis of critically ill patients in ICU. |
| Key words: Malnutrition Critically ill patient Subjective globle assessment Nutrition assessment |
