Correlation between controlling nutritional status score and infectious complications in trauma patients

XU Yao; YE Xiang-hong; LI Jia-qi; ZUO Jun-tao

doi:10.16048/j.issn.2095-5561.2024.01.08

Abstract：Objective To explore the correlation between controlling nutritional status (CONUT) score and infectious complications in trauma patients. Methods The clinical data of 141 trauma patients admitted to Intensive Care Unit (ICU) of the General Hospital of Eastern Theater Command from December 2021 to December 2022 were retrospectively analyzed. According to the presence or absence of infectious complications,they were divided into group A (without infectious complications,n=82) and group B (with infectious complications,n=59). The related factors that may lead to infectious complications of patients were collected,including basic data,treatment measures and laboratory examination indicators. Logistic regression was used to analyze the risk factors of infectious complications. Spearman correlation analysis was used to analyze the correlation between CONUT score and nutritional risk screening 2002 (NRS 2002) and serum albumin (ALB). Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of CONUT score for infectious complications in trauma patients, and DeLong non-parametric test was used to compare the area under the ROC curve(AUC) of each index for predicting infectious complications. Results Spearman correlation analysis showed that the CONUT score was positively correlated with NRS 2002 (r=0.921,P<0.001),and CONUT score was negatively correlated with ALB (r=-0.827,P<0.001). Multivariate Logistic regression analysis showed that mechanical ventilation time,injury severity scores (ISS),CONUT score,operation duration,and ICU length of stay were independent risk factors for infectious complications in trauma patients (P<0.05). ROC curve results showed that the AUC of CONUT score,NRS 2002,and ALB for predicting infectious complications in trauma patients were 0.796[95％ credibility interval (CI): 0.722-0.869],0.748 (95％ CI: 0.672-0.824), and 0.732 (95％ CI: 0.646-0.818),respectively. The maximum Youden index value of CONUT score,NRS 2002,and ALB for predicting infectious complications in trauma patients were 0.511,0.478,0.431 and the cut-off values were 5 scores,3 scores and 35.4 g/L,respectively. DeLong non-parametric test showed that the AUC of CONUT score in predicting infectious complications in trauma patients was higher than that of NRS 2002 (Z=2.072) and ALB (Z=2.198),and the differences were statistically significant (P<0.05). Conclusions Mechanical ventilation time,ISS,CONUT score, operation duration,and ICU length of stay are independent risk factors for infectious complications in trauma patients.CONUT score is better than NRS 2002 and ALB in predicting infectious complications.When CONUT score is≥5 scores,the nutritional status of trauma patients is worse and the risk of infectious complications is increased.