The efficacy of nutritional and inflammatory markers in length of hospital stay and mortality prediction in severely malnourished patients Ciddi malnütrisyon hastalarinda nütrisyonel ve inflamatuar belirteçlerin hastanede kaliş süresi ve mortaliteyi öngörmedeki etkinliǧi
Nobel Medicus, cilt.9, sa.2, ss.79-85, 2013 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 9 Sayı: 2
- Basım Tarihi: 2013
- Dergi Adı: Nobel Medicus
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.79-85
- Anahtar Kelimeler: Albumin, CRP, Ferritin, Malnutrition, NRS-2002, Prealbumin
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Malnutrition and inflammation parameters are strongly correlated with prospective length of hospital stay and mortality. In this study, we studied the predictive roles of NRS-2002 score, serum prealbumin, albumin, CRP and ferritin levels in length of hospital stay and mortality in severely malnourished patients. Material and Method: A total of 397 intensive care unit patients with NRS-2002 score ≥3 and total parenteral nutrition supplementation were included in the study. Patients were divided into two groups based on whether they were discharged (group 1) or deceased (group 2). Patients were evaluated at hospitalization and prior to patients' discharge or death. Results: Mean duration of intensive care unit hospitalizations in group 1 and 2 were 11.97±10.57 and 13.43±12.67 days respectively (p=0.45). In group 1, NRS-2002 score of the patients were found to be decreased during the final evaluation. The initial and final measurement of serum CRP levels of group 2 were significantly higher than the CRP levels of group 1. The initial and final prealbumin and albumin levels for group 2 were significantly lower than prealbumin and albumin levels for group 1. Albumin was found to be the most specific predictor for mortality determination with 91% specificity, and 86% sensitivity. Sensitivity of prealbumin was found to be 59% for assessing the malnutrition with a specificity of 70%. Specificity for using CRP as an indicator of mortality was 87% with 93% sensitivity. Ferritin levels did not show any significance in predicting prognosis. The logistic regression analysis of multivariable model yielded the risk factors for hospital mortality as high CRP at admission, and prealbumin levels. Conclusion: Serum albumin, prealbumin and CRP levels were shown to be associated with mortality prediction.