慢性心力衰竭患者营养不良风险预测模型的构建及验证

doi:10.3761/j.issn.0254-1769.2021.03.001

摘要/Abstract

摘要：

目的构建慢性心力衰竭患者营养不良风险预测模型,并验证该模型的预测效果。方法 2019年1月—2020年1月,选择镇江市某三级甲等医院心血管内科住院的109例患者作为模型建立对象,将其分为营养不良组（40例）和营养正常组（69例）。采用Logistic回归建立慢性心力衰竭患者营养不良风险预测模型,采用Hosmer-Lemeshow和受试者操作特征曲线分别检验模型的拟合优度及预测效果,并纳入72例患者对模型进行验证。结果慢性心力衰竭患者营养不良发生率为40.33%;营养不良的影响因素分别为：年龄（OR=3.835）、吸烟（OR=8.091）、血清总蛋白（OR=9.103）、C反应蛋白（OR=5.947）和水肿（OR=5.709）。Hosmer-Lemeshow检验P=0.623,受试者操作特征曲线下面积为0.882,约登指数为0.582,最佳临界值为0.604,灵敏度为0.625,特异度为0.957,实际应用的正确率为81.94%。结论该研究构建的风险预测模型效果良好,可为临床评估慢性心力衰竭患者的营养风险提供借鉴。

关键词: 慢性心力衰竭, 营养不良, 风险预测模型, 护理

Abstract:

Objective To construct a risk prediction model for malnutrition in patients with chronic heart failure,and verify the prediction effect of the model. Methods From January 2019 to January 2020,109 patients hospitalized in the Department of Cardiovascular Medicine of a tertiary hospital in Zhenjiang were selected as the subjects of model establishment. They were divided into a malnutrition group（40 cases） and a normal nutrition group（69 cases）.Logistic regression analysis model was used to establish the influencing factors of the subjects. Hosmer-Lemeshow and receiver operating characteristic curve were used to test the goodness of fit and predictive effect of the model,and 72 patients were included again in the application research of the model. Results The incidence of malnutrition in patients with chronic heart failure was 40.33%. The risk factors for malnutrition were age（OR=3.835）,smoking（OR=8.091）,total serum protein（OR=9.103）,C-reactive protein（OR=5.947）,and edema（OR=5.709）.Hosmer-Lemeshow test P=0.623;the area under the receiver operating characteristic curve was 0.882;the Youden index was 0.582;the best critical value was 0.604;the sensitivity was 0.625;the specificity was 0.957,and the actual application accuracy rate was 81.94%. Conclusion The risk prediction model constructed in this study has a good effect and can provide references for clinical screening of nutritional risks in patients with chronic heart failure.

Key words: Chronic Heart Failure, Malnutrition, Risk Prediction Model, Nursing Care

惠宁, 张文杰. 慢性心力衰竭患者营养不良风险预测模型的构建及验证[J]. 中华护理杂志, 2021, 56(3): 325-329.

HUI Ning, ZHANG Wenjie. Construction and evaluation of a model for predicting malnutrition risk in patients with chronic heart failure[J]. Chinese Journal of Nursing, 2021, 56(3): 325-329.

图/表 4

Table 1 Univariate analysis of malnutrition in patients with chronic heart failure[n=109,case（percent,%）]

Table 2 Assignment table of independent variables

Table 3 Logistic regression analysis of malnutrition in patients with chronic heart failure（n=109）

Figure 1 ROC curve of the risk prediction model for malnutrition in patients with chronic heart failure

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