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Derivation and validation of a new nutritional index for predicting 90 days mortality after ICU admission in a Korean population

Authors
 Da-Hye Son  ;  Kyung-Sub Kim  ;  Hye-Sun Lee  ;  Ji-Won Lee  ;  Cheung-Soo Shin 
Citation
 JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION, Vol.119(8) : 1283-1291, 2020-08 
Journal Title
 JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION 
ISSN
 0929-6646 
Issue Date
2020-08
Keywords
Critical care ; Mortality ; Nutritional status ; Prediction
Abstract
Background/purpose: Predicting the mortality in patients admitted to the ICU is important for determining a treatment strategy and public health policy. Although many scores have been developed to predict the mortality, these scores were based on Caucasian population. We aimed to develop a new prognostic index, the New nutritional index (NNI), to predict 90-days mortality after ICU admission based on Korean population. Methods: Patients (1453) who admitted intensive care unit (ICU) of the Gangnam Severance hospital were analyzed. After exclusion, 984 patients were randomly divided into internal (n = 702) and external validation (n = 282) data set. The new nutritional index (NNI) was developed using univariate and multivariate logistic regression with backward selection of predictors. Receiver operating characteristic (ROC) curve analysis and comparison of the area under the curve (AUC) verified the better predictor of 90 days-mortality after ICU admission. Results: The NNI better predicted 90 days-mortality compared to modified NUTRIC score, APACHE II scores, SOFA scores, CRP, glucose, total protein, and albumin level in internal and external data sets, with AUC of 0.862 (SE: 0.017, 95% CI: 0.829-0.895) and 0.858 (SE: 0.015, 95% CI: 0.829-0.887), respectively. The calibration plots using external data set for validation showed a close approximation to the logistic calibration of each nomogram, and p-value of Hosmer and Lemeshow test was 0.1804. Conclusion: The NNI has advantages as a predictor of 90 days mortality based on nutritional status in the Korean population.
Full Text
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0929664620301807
DOI
10.1016/j.jfma.2020.05.007
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sub(김경섭)
Son, Da‐Hye(손다혜) ORCID logo https://orcid.org/0000-0001-7464-996X
Shin, Cheung Soo(신증수) ORCID logo https://orcid.org/0000-0001-7829-8458
Lee, Ji Won(이지원) ORCID logo https://orcid.org/0000-0002-2666-4249
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179702
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