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Effects of APACHE II Score and Initial Nutritional Status on Prognosis of the Critically Ill Patients

机译：APACHE II评分和初始营养状况对重症患者预后的影响

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BACKGROUND: Malnutrition is common in hospitalized patients, especially in critically ill patients and affects their mortality and morbidity. However, the correlation between malnutrition and poor outcome is not fully understood. Our hypothesis is that the nutritional effect on the patient's prognosis would differ depending on the severity of the disease. METHODS: 3,758 patients admitted to the intensive care unit (ICU) were observed retrospectively. Patients were divided into well, moderate and severe groups, according to their nutritional status as assessed by their serum albumin level and total lymphocyte count (TLC). The severity of the disease was assessed by the Acute Physiologic and Chronic Health Evaluation (APACHE II score). All patients were followed clinically until discharge or death and ICU days, hospital days, ventilator days, and mortality rates were recorded. RESULTS: Depending on the definition used, the prevalence of hospital malnutrition is reported to be 68.3%. Hospital days, ICU days, as well as ventilator days of moderate and severe groups were longer than the well group. In patients exhibiting mild severity of disease, moderate and severe malnutrition groups have 3-5 times the mortality rate than the well group. CONCLUSIONS: Malnutrition affects the prognosis of patients who have an APACHE II score ranging from 4-29 points. Active nutritional support may be more effective for patients with a disease of mild severity.
机译：背景：营养不良在住院患者中很常见，尤其是在重症患者中，并影响其死亡率和发病率。但是，营养不良与不良结局之间的相关性尚未得到充分理解。我们的假设是，根据疾病的严重程度，营养对患者预后的影响会有所不同。方法：回顾性分析3758例重症监护病房（ICU）的患者。根据通过血清白蛋白水平和总淋巴细胞计数（TLC）评估的营养状况，将患者分为好，中和重度组。通过急性生理和慢性健康评估（APACHE II评分）评估疾病的严重程度。对所有患者进行临床随访，直至出院或死亡，并记录ICU天数，住院天数，呼吸机天数和死亡率。结果：根据所使用的定义，据报告医院营养不良的患病率为68.3％。中度和重度组的住院天数，ICU天数以及呼吸机天数比健康组更长。在表现出轻度疾病严重程度的患者中，中度和重度营养不良组的死亡率是健康组的3-5倍。结论：营养不良影响APACHE II评分为4-29分的患者的预后。积极的营养支持可能对轻度疾病患者更为有效。

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