The Value Of Nutrition-related Indicators For Nutritional Risk Screening In Children With Severe Pneumonia

Purpose:To investigate the prevalence of nutritional risk in children with severe pneumonia,analyze its relationship with age,gender and clinical outcomes,and explore the value of nutrition-related indicators for nutritional risk screening in children with severe pneumonia.Methods:The nutritional risk screening tool(STRONG_kids)is used to investigate the prevalence of nutritional risk in 188 children with severe pneumonia,and the relationship between nutritional risk and clinical outcomes was analyzed based on the cost of hospitalization,the length of hospital stay,the number of organ damage and the prognosis of disease.Hemoglobin,total protein,albumin and other nutrition-related indicators were collected.Values of these indicators for nutritional risk screening of children with severe pneumonia were analyzed by the receiver operating characteristic?ROC?curve.The best cut-off point of every indicators were determined according to Youden index.Three indicators were included in Logistic regression analysis for the probability of the predicted index of multi-factor fusion and alayzed the value of probability of the predicted index for nutritional risk screening of patients by the ROC curve.Results:among 188 children with severe pneumonia,high nutritional risk accounted for 42.6%,moderate nutritional risk accounted for 42.0%,and low nutritional risk accounted for 15.4%,that is,84.6%of the children had nutritional risk.Children were divided into infant group,toddler group,preschool group and school age group according to the age of the children.The prevalence of nutritional risk in each age group was91.3%,84.0%,70.0%and 60.0%.Children with high nutritional risk were mainly distributed in the infant group who were less than 1 years old,children with moderate nutritional risk were mainly distributed in 1-3years old,and the difference was statistically significant.The prevalence of nutritional risk of male children was 82.8%,and the prevalence of nutritional risk of female children was 87.5%.The prevalence of nutritional risk was not related to gender.Compared with the group without nutritional risk,the group with nutritional risk had higher the cost of hospitalization,longer the length of hospital stay,more organs damage and worse prognosis of disease.The differences were statistically significant.Area under the ROC curve of hemoglobin in predicting nutritional risk was 0.741,the sensitivity and specificity were 75.9%,69.8%when we set the cut-off point at 113.5 g/L.Area under the ROC curve of total protein in predicting nutritional risk is 0.768,the sensitivity and specificity were 82.8%,66.0%when we set the cut-off point at 62.95 g/L.Area under the ROC curve of albumin in predicting nutritional risk is0.680,the sensitivity and specificity were 62.1%,66.0%when we set the cut-off point at 39.75 g/L?all P<0.05?.The univariate analysis of the three groups grouped by the best threshold showed that there was a significant difference in nutritional risk between the two groups grouped by the best threshold?P<0.05?.Combined evaluation of these three indicators shows a high predictive value:area under the ROC curve is0.805,the sensitivity was 82.8%and the specificity was72.3%?P<0.05?.Conclusion:The prevalence of nutritional risk is high in children with severe pneumonia,especially in infants younger than 1 year old.Children with severe pneumonia who are at nutritional risk have higher the cost of hospitalization,longer the length of hospital stay,more organ damage and worse prognosis of disease.In clinical work,attention should be paid to their nutritional risk screening.Hemoglobin,total protein and albumin have good values in nutritional risk screening of children with severe pneumonia.The combination of three indicators diagnostic model can improve the assessment value.