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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1481279

Development and validation of risk prediction model for feeding intolerance in neurocritical patients with enteral nutrition

Provisionally accepted
Rong Yuan Rong Yuan 1Lei Liu Lei Liu 1Jiao Mi Jiao Mi 1Xue Li Xue Li 1Fang Yang Fang Yang 2Shifang Mao Shifang Mao 3*
  • 1 Neurological Intensive Care Unit, Deyang People's Hospital, Deyang, China
  • 2 Department of Nursing, Deyang People's Hospital, Deyang, China
  • 3 Department of Nursing, Affiliated Hospital of Southwest Medical University, Luzhou, China

The final, formatted version of the article will be published soon.

    Background: This study collects and analyzes the clinical data of enteral nutrition therapy in neurocritical patients, constructs and validates the feeding intolerance (FI) risk prediction model, and provides a theoretical basis for screening patients with high risk of FI and personalized care. Methods: A convenience sampling method was adopted to select 300 patients who were admitted to a tertiary hospital in China for early enteral nutrition therapy in the neurointensive care unit from April 2022 to December 2022, and independent risk factors for FI were screened by using univariate and logistic regression analyses to establish a prediction model, and to evaluate the goodness of fit of the model and discriminant validity. Results: The incidence of FI in neurocritical patients receiving enteral nutrition was 71%. Logistic regression analysis showed that age, Glasgow Coma Scale (GCS) scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, mechanical ventilation, feeding via nasogastric tube route, hyperglycemia, and low serum albumin were independent risk factors for the development of FI (P < 0.05). A predictive formula for the risk of FI was established as Logit P = -14.737 + 1.184 × mechanical ventilation + 2.309 × feeding route + 1.650 × age + 1.336 × GCS tertile (6-8 points) + 1.696 × GCS tertile (3-5 points) + 1.753 × APACHE II score + 1.683 × blood glucose value + 1.954 × serum albumin concentration. The Hosmer-Lemeshow test showed the χ2 value=9.622，p = 0.293, and the area under the ROC curve was 0.941 (95% confidence interval: 0.912–0.970, P＜0.001). The optimal critical value was 0.767, the sensitivity was 85.9%, the specificity was 90.8%, and the Youden index was 0.715. Conclusion: The early enteral nutrition FI risk prediction model constructed in this study demonstrated good predictive ability. This could serve as a reference basis for the effective clinical assessment of the risk of FI occurrence in neurocritical patients.

    Keywords: Neurocritical, Feeding intolerance, Risk factors, Prediction model, Enteral Nutrition

    Received: 15 Aug 2024; Accepted: 04 Oct 2024.

    Copyright: © 2024 Yuan, Liu, Mi, Li, Yang and Mao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Shifang Mao, Department of Nursing, Affiliated Hospital of Southwest Medical University, Luzhou, China

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