| Objective:Through literature analysis and expert letter inquiry,the predictors of malnutrition in elderly patients with pulmonary heart disease were investigated,the risk warning model was constructed,and the malnutrition risk warning model of elderly patients with pulmonary heart disease was verified,in order to provide certain nutritional evaluation indicators for elderly patients with pulmonary heart disease.Methods:1.In this study,patients with chronic cor pulmonale(Chronic Pulmonary Hearth Disease,CPHD)who met the inclusion exclusion criteria hospitalized in the geriatric research center of a Grade A hospital in Inner Mongolia Autonomous Region from December 2021 to December2022 were selected,and the miniature Nutrition Evaluation Scale(MNA-SF)was used to evaluate whether CPHD patients had nutritional risk.Patients with CPHD were divided into the nutritional risk group and the nutritional normal group.Relevant information of CPHD patients was collected through general data questionnaire,objective physiological and biochemical indicators,Pittsburgh Sleep Quality Index Evaluation Scale(PSQI),Activities of daily living Ability Evaluation Scale(ADL),and Hamilton Anxiety Scale(HAMA).Univariate analysis and multivariate Logistic regression analysis were used to screen out the influencing factors of malnutrition in elderly CPHD patients,forming a risk warning model for malnutrition in elderly patients with pulmonary heart disease.2.Elderly patients with pulmonary heart disease in a hospital in Inner Mongolia Autonomous Region from January 2023 to the end of March 2023 were selected as the validation group,and the patients were divided into nutritional normal group and nutritional risk group by MNA-SF.Firstly,the general data of the modeling group and the validation group were compared without significant difference;then the occurrence of the nutritional normal group and the nutritional risk group was calculated through the prediction model,and the ROC curve was compared,the area under the ROC curve was used to evaluate the differentiation of the model,and the accuracy,sensitivity and specificity of the model were obtained according to the four-grid table data.Results:1.In this study,419 elderly patients with cor pulmonale were included into the modeling group,among which 370 patients with nutritional risk were 88.3%,and 49 elderly patients with normal nutrition,accounting for 11.7%.2.Univariate analysis of influencing factors of elderly CPHD patients malnutrition,the results showed: gender,age,income,cultural level,dyspnea,anorexia,dysphagia,disease stage,slow disease,multiple drugs,sodium,potassium,BNP,heart function classification,anxiety,daily life activities,sleep quality 17 factors have statistical significance(P <0.05).3.After multivariate Logistic regression analysis,the results showed that five factors: age,economic income,anxiety,ability of daily life activities and sleep quality entered the model,among which age,anxiety and sleep quality were the risk factors of nutritional risk,and high economic income and increased ability of daily life activities were the protective factors of nutritional risk.The area under the ROC curve of the model constructed in this study is 0.906,the model predicted specificity is 0.959 and the sensitivity is 0.692.4.In the validation group of this study,132 elderly patients with heart or pulmonary heart disease were included,and their age,economic income,anxiety score,daily activity ability and sleep quality index were added into the equation for the external validation of the malnutrition model in elderly patients with CPHD.Finally,the area under the ROC of the curve obtained the prediction model of 0.899,the specificity of the model of 0.895 and the sensitivity of 0.92,which proved that the model had good predictivity.Conclusions:1.The risk warning model of malnutrition in elderly pulmonary heart disease,composed of age,economic income,anxiety degree,ability of daily life activities and sleep quality,can predict whether there is nutritional risk in elderly patients with pulmonary heart disease early.The model shows that age,anxiety and sleep quality are the risk factors for nutritional risk,the heavier,the more likely the risk of malnutrition;economic income and daily life activities are the protective factors of nutritional risk,which are negatively correlated with the occurrence of nutritional risk.2.Institute of elderly patients with pulmonary heart disease malnutrition risk prediction model of the sensitivity and specificity is higher,can effectively predict the risk of malnutrition in elderly patients with pulmonary heart disease,can be used as an evaluation prediction tool,help medical staff early detection of elderly pulmonary heart disease malnutrition may,and can develop as soon as possible about such patients malnutrition treatment and nursing work. |
