| Objectives Two nutritional assessment methods,NRS-2002 and mNUTRIC score,were used to screen the nutritional risk of patients with severe cerebral infarction,and to explore the evaluation value of clinical prognosis of patients with severe cerebral infarction using NRS-2002 and mNUTRIC score.Methods A total of 200 patients with severe cerebral infarction who were hospitalized in The Department of Neurology,Affiliated Hospital of North China University of Science and Technology from October 2020 to October 2021 were selected.General and clinical data were collected,nutritional risk screening 2002(NRS-2002)and modified nutrition risk in critically ill(mNUTRIC)score were used to screen nutritional risk of patients,and the occurrence of lung infection,mechanical ventilation and length of hospital stay during hospitalization were recorded.Prognosis of patients at 1 month and 3 months were observed,and they were divided into survival group and death group.The differences in various indicators including nutritional risk score were compared between the two groups,and the independent risk factors affecting prognosis at 1 and 3 months were analyzed by multi-factor binary Logistic regression.The two nutrition scores were divided into groups to compare the prognosis of each group.Finally,the evaluation value of NRS-2002,mNUTRIC score and their combination for 1 and 3 months prognosis in patients with severe cerebral infarction was compared by using the receiver operating characteristic curve.Results 1 A total of 192 patients were included due to the exclusion of 8 patients who could not be contacted and refused follow-up.2 After 1 month,147 patients with severe cerebral infarction survived and 45 died,and the fatality rate was 23.4%.The comparison of basic characteristics between the survival group and the death group showed that there were statistically significant differences in APACHEⅡ score,SOFA score,length of hospital stay,hypertension,mechanical ventilation and pulmonary infection(P<0.05).Nutritional score comparison,the results showed that NRS-2002 and mNUTRIC scores in the death group were higher than those in the survival group,and the difference was statistically significant(P<0.05).Multivariate binary Logistic regression analysis showed that NRS-2002,mNUTRIC score,hypertension and mechanical ventilation were independent risk factors for 1-month death in patients with severe cerebral infarction(P<0.05).3 After 3 months,116 patients with severe cerebral infarction survived and 76 died,with a mortality rate of 39.6%.The comparison of basic characteristics between the survival group and the death group showed that there were statistically significant differences in hypertension,APACHEⅡ score,mechanical ventilation,pulmonary infection and length of hospital stay(P<0.05).Nutritional score comparison,the results showed that NRS-2002 and mNUTRIC scores in the death group were higher than those in the survival group,and the difference was statistically significant(P<0.05).Multivariate binary Logistic regression analysis showed that hypertension,mNUTRIC score,mechanical ventilation and pulmonary infection were independent risk factors for 3-month death in patients with severe cerebral infarction(P<0.05).4 According to the NRS-2002 score,patients with NRS-2002<3 were divided into non-nutritional risk group,patients with 3≤NRS-2002<5 were divided into nutritional risk group and patients with NRS-2002≥5 were divided into high nutritional risk group.6.8% of patients had no nutritional risk and 57.3% had nutritional risk.35.9% of patients had high nutritional risk.By comparing the prognostic differences between the nutritional risk group and the high nutritional risk group,the 1-month mortality and 3-month mortality of the high nutritional risk group were44.9% and 62.3%,respectively,which were significantly higher than those of the nutritional risk group,with statistical significance(P<0.05).According to mNUTRIC score,patients with mNUTRIC<5 were divided into low nutritional risk group,patients with mNUTRIC≥5 were divided into high nutritional risk group,68.8% of patients with low nutritional risk were screened,31.2% of patients with high nutritional risk were screened.By comparing the prognostic differences between the low nutrition risk group and the high nutrition risk group,the 1-month and 3-month mortality rates of the high nutrition risk group were 50% and 61.7%,respectively,which were significantly higher than the 1-month and 3-month mortality rates of the low nutrition risk group,with statistical significance(P<0.05).5 According to ROC curve,the area under the curve of NRS-2002,mNUTRIC score and their combined prediction of one-month mortality were 0.750,0.811,0.823,sensitivity were 68.9%,66.7%,80%,specificity was 74.1%,85.0%,68%,respectively.The optimal cut-off value of NRS-2002 score was 4 points,and that of mNUTRIC score was 4 points.The ROC curve showed that the area under the curve for mNUTRIC score to predict 3-month mortality was 0.759,the sensitivity was 80.3%,the specificity was 61.2%,and the optimal cut-off value was 3points.Conclusions 1 NRS-2002 and mNUTRIC score were correlated with the prognosis of patients with severe cerebral infarction at 1 month,while mNUTRIC score was correlated with the prognosis of patients with severe cerebral infarction at 3 months.2 Different nutritional risks of NRS-2002 and mNUTRIC scores were significantly correlated with the mortality at 1 and 3 months in patients with severe cerebral infarction,and the higher the risk,the higher the mortality.3 Both NRS-2002 and mNUTRIC score had evaluation value for one-month death of patients with severe cerebral infarction,and mNUTRIC score was more effective than NRS-2002.Compared with the two tests alone,the combined test of NRS-2002 and mNUTRIC score improved the evaluation value.4 mNUTRIC score had a good evaluation value for 3-month death from severe cerebral infarction,but NRS-2002 did not.Figure 2;Table 10;Reference 137... |
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