Development And Validation Of A Prediction Model For Refeeding Syndrome In ICU Patients Undergoing Enteral Nutrition

Research Purpose:To analyze the risk factors of refeeding syndrome in ICU patients with enteral nutrition,and develop the risk prediction model and the risk assessment scale of refeeding syndrome in ICU patients with enteral nutrition,so as to provide an evaluation tool for screening high-risk population of refeeding syndrome.Research Methods:Relevant information of 433 patients who received enteral nutrition from January 2018 to July2020 in ICU of a tertiary hospital in Zhejiang was retrospectively analyzed adopting convenience sampling.The patients were divided into refeeding syndrome group and non-refeeding syndrome group.Logistic regression was used to establish a risk prediction model and a risk assessment scale Which tested 120 patients with enteral nutrition in ICU who lived in tertiary hospital in Zhejiang,and the actual prediction ability of prediction model and risk assessment scale ware verified respectively.Research Results:The incidence of refeeding syndrome in 433 patients with enteral nutrition in ICU was30.02%.Logistic regression analysis showed that Nutritional Risk Screening 2002,albumin,prealbumin,history of diabetes,perfusion route,temperature of the nutrition liquid,protein intake,calorie intake and perfusion speed were the risk factors of refeeding syndrome in ICU enteral nutrition patients(P<0.05).The Hosmer-Lemeshow test showed P= 0.129(> 0.05),and the area under the ROC curve is 0.913 with the sensitivity of 82.3%,the specificity of 89.4% and the Youden index was 0.717.The prospective validation results showed that the Hosmer-Lemeshow test showed P= 0.676(> 0.05),the area under the ROC curve was 0.882 with the sensitivity of 89.5%,the specificity of 74.4%,the Youden index was 0.639,the prediction accuracy of the risk modle is 80%.The prediction accuracy of the risk assessment scale is 79.2%.Compared with the prediction results of the model and the scale,the Kappa identity test is 0.843,P < 0.001.Research Conclusion:The risk prediction model and risk assessment scale of feeding syndrome in ICU patients with enteral nutrition constructed in this study have a good prediction ability,and can provide an evaluation tool for ICU nurses to screen high-risk groups of refeeding syndrome.