关键词: 重症患者；脑出血；肠内营养；误吸；危险因素；预测模型

Abstract: Objective: To analyze the risk factors of aspiration in patients with severe intracerebral hemorrhage receiving enteral nutrition support, and preliminary develop and verify its risk prediction graph model. Methods: Retrospective cohort study method was used to systematically select patients with severe cerebral hemorrhage who received enteral nutrition support from a tertiary grade A hospital in Liaoning province from January 2018 to March 2021. According to whether aspiration occurred or not, they were divided into non-aspiration group (n=221) and aspiration group (n=147). Logistic regression was used to analyze the risk factors of aspiration, and R software was used to build a risk prediction nomogram model. From April 2021 to June 2021, 53 patients with severe cerebral hemorrhage who received enteral nutrition support in the same hospital were selected to validate the model. Results: Logistic regression analysis screened the nasogastric feeding tube diameter (OR=0.080), gastric residual volume (OR=1.710), history of aspiration (OR=0.356), National Institute of Stroke Scale score (OR=1.257) and low-water drinking test (OR=2.499) were the risk factors for aspiration (P<0.05). Internal validation showed that the area under the ROC curve was 0.955, the risk prediction value corresponding to the maximum value of the Youden index was 0.234, and the slope of the calibration curve was close to 1. External validation showed that the area under ROC curve was 0.891, calibration curve was near ideal curve. Conclusion: The differentiation and accuracy of the constructed linear graph model are high, which can provide a reference for predicting the risk of aspiration in patients with severe intracerebral hemorrhage receiving enteral nutrition support.

Key words: critical patient; cerebral hemorrhage; enteral nutrition; aspiration; risk factor; prediction model