Study On The Correlation Between Sequential Enteral Nutrition Therapy And Co-infection In Patients With Cerebral Infarction Based On MIMIC-Ⅲ Database Analysis

Objective:Through clinical observation of acute cerebral infarction patients with different enteral nutrition treatment protocols,the efficacy of sequential enteral nutrition therapy was explored to lay the theoretical foundation for early nutritional management of acute cerebral infarction patients.Methods:A retrospective analysis of eligible patients in the Medical Information Mart for Intensive Care(MIMIC-III)data base,a repository of medical information collected in intensive care,was performed.A total of 200 patients with acute cerebral infarction were enrolled in accordance with the inclusion and exclusion criteria,who were classified on the basis of their different enteral nutrition regimens.The patients were divided into a sequential group(n=110 patients)and non-sequential group(n=90 patients),and the Glasgow Coma Scale(GCS)scores,albumin,leukocytes,platelets,bicarbonate,sodium ion,potassium ion,international normalized ratio(INR),and prothrombin time(PT),as well as the occurrence of infections during treatment were collected.The collected data were statistically analyzed by SPSS26.0 statistical software,which means that the measurement data of the data obeyed normal distribution and homogeneity of variance were denoted by mean±standard deviation(χ±s),while the independent samples t-test was adopted for comparison between groups.If the measurement data did not satisfy normality and homogeneity of variance,the rank sum test was adopted;the measurement data were expressed as percentages(%)by employing theχ~2test;constructing a binary logistic regression equation to explore factors associated with infection.P<0.05 denotes a statistically significant difference.Results:(1)After 7 days of treatment,GCS score,albumin,bicarbonate,sodium ion,potassium ion,INR,and PT in the sequential group increased in comparison to the first day,while neutrophils decreased in comparison to the first day.In this regard,they were all significantly different and statistically significant in comparison to the first day(P<0.05),while platelets,leukocytes,urea nitrogen,creatinine,and glucose were not significantly different and not statistically significant in comparison to the first day(P>0.05).After 7 days of treatment,GCS score,albumin,bicarbonate,sodium ion,potassium ion,INR,and PT increased in the non-sequential group in comparison to the first day,while neutrophils decreased in comparison to the first day,which were all significantly different and statistically significant in comparison to the first day(P<0.05).On the other hand,platelets,leukocytes,urea nitrogen,creatinine,and glucose were not significantly different and not statistically significant in comparison to the first day(P>0.05).(2)Comparing patients in the sequential group and non-sequential group after 7days of treatment:following treatment,albumin was higher in the sequential group(4.64±0.72 g/dl)than that of the non-sequential group(4.42±0.83 g/dl),which demonstrated a significant difference with statistical significance between the two groups(P<0.05).There was no significant difference in GCS score,platelets,leukocytes,bicarbonate,urea nitrogen,creatinine,glucose,sodium ion,potassium ion,neutrophils,INR and PT between the two groups,which was not statistically significant(P>0.05).(3)The sequential group was characterized by 25 cases(22.7%)of infectious complications during treatment,and 85 cases(77.3%)of no infectious complications,while the non-sequential group was characterized by 38 cases(42.2%)of infectious complications during treatment,and 52 cases(57.8%)of no infectious complications.The incidence of infectious complications during treatment was higher in the non-sequential group than in the sequential group,which demonstrated a significant difference with statistical significance in comparison between the two groups(χ~2=8.72;P<0.001).(4)GCS score,platelets,leukocytes,albumin,bicarbonate,urea nitrogen,creatinine,glucose,sodium ion,potassium ion,neutrophils,INR,PT were included to construct a binary logistic regression equation.The results identified that the higher the leukocytes,the higher the risk of infection,which was statistically significant(OR=2.15,95%CI 1.57-2.93,P<0.001);the lower the albumin,the higher the risk of infection,which was statistically significant(OR=0.31,95%CI 0.15-0.65,P<0.001).Furthermore,the GCS score,platelets,bicarbonate,urea nitrogen,creatinine,glucose,sodium ion,potassium ion,neutrophils,INR and PT did not correlate with infection,which were not statistically significant(P>0.05).Conclusions:1.Both sequential and non-sequential enteral nutrition therapy are capable of improving the GCS score of patients,improving their state of consciousness and ensuring the stability of the internal environment.2.The sequential enteral nutrition therapy is more conducive to increasing the serum albumin level and reducing the incidence of infectious complications than the non-sequential enteral nutrition therapy.