mNUTRIC与NRS2002评分对血液重症监护病房中伴脓毒症血液肿瘤患者死亡风险的预测价
Predictive value of the mNUTRIC and NRS2002 scores for mortality risk in septic patients with hematological malignancies admitted to a hematology critical care unit

张东阳.mNUTRIC与NRS2002评分对血液重症监护病房中伴脓毒症血液肿瘤患者死亡风险的预测价[J].内科急危重症杂志,2026,32(2):125-129

DOI：10.11768/nkjwzzzz20260205

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作者	单位	E-mail
张东阳		Fansjhmu@163.com

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中文摘要:

摘要目的：评估改良危重症营养风险（mNUTRIC）评分与营养风险筛查2002（NRS2002）对伴脓毒症的血液肿瘤重症患者28 d全因死亡率的独立预测价值。方法：回顾性纳入279例患者。收集人口学、临床及营养评分数据，通过单因素及多因素Logistic回归分析筛选死亡独立预测因素，并采用受试者工作特征（ROC）曲线评估评分预测效能。结果：校正年龄、体重指数（BMI）、急性生理学与慢性健康状况评估（APACHEⅡ）评分和序贯器官衰竭评分（SOFA）后，较高的mNUTRIC评分（OR=1.312）与NRS2002评分（OR=1.338）仍是住院死亡风险增加的独立预测因素。mNUTRIC评分预测死亡的曲线下面积（AUC）为0.657（最佳截断值5.5分），NRS2002评分的AUC为0.645（最佳截断值4.5分）。两者AUC置信区间存在重叠，提示预测效能差异无统计学意义。结论：mNUTRIC与NRS2002评分可作为伴脓毒症的血液肿瘤重症患者住院死亡率的独立预测工具，有助于早期识别高危患者并指导临床干预。

英文摘要:

Abstract Objective: To evaluate the independent predictive value of the modified Nutrition Risk (mNUTRIC) score and the Nutrition Risk Screening 2002 (NRS2002) for 28-day all-cause mortality in critically ill septic patients with hematological malignancies. Methods: This retrospective cohort study enrolled 279 patients. Demographic, clinical, and nutritional score data were collected. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of mortality, and the predictive performance of the scores was assessed using receiver operating characteristic (ROC) curve analysis. Results: After adjustment for age, body mass index (BMI), acute physiological assessment and chronic health evaluation II (APACHE II), and sequential organ failure assessment (SOFA) scores, higher mNUTRIC (OR= 1.312) and NRS2002 (OR= 1.338) scores remained independent predictors of increased 28-day all-cause mortality. The area under the ROC curve (AUC) for mNUTRIC was 0.657 (optimal cut-off: 5.5), and that for NRS2002 was 0.645 (optimal cut-off: 4.5). The overlapping confidence intervals of the AUCs indicated no statistically significant difference in predictive performance between the two scores. Conclusion: Both the mNUTRIC and NRS2002 scores are independent predictors of 28-day all-cause mortality in this patient population. Their proactive clinical application may facilitate early identification of high-risk patients and guide therapeutic interventions.