Risk Factors and Prediction Model for Enteral Nutrition-Associated Diarrhea in Neurocritical Care Patients

doi:10.16048/j.issn.2095-5561.2025.01.13

Abstract：Objective To explore the risk factors for enteral nutrition-associated diarrhea (ENAD) in neurocritical care patients and to establish a predictive model for ENAD. Methods A total of 305 neurocritical care patients admitted to Huai'an Second People's Hospital from July 2021 to September 2023 were selected as the study subjects. There were 178 males and 127 females, with an average age of (61.66±7.31) years, ranging from 38 to 84 years. Data on general information, baseline conditions, enteral nutrition status, and treatment were collected for univariate analysis. Multivariate analysis was used to screen for risk factors of ENAD. A nomogram prediction model for ENAD was constructed based on the risk factors. Results Among the 305 patients, the incidence of ENAD was 31.5% (96/305). There were statistically significant differences between the two groups in terms of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, the proportion of hypoproteinemia, the fasting time before enteral nutrition, the daily enteral nutrition infusion volume, the infusion rate of enteral nutrition, the duration of enteral nutrition application, the proportion of acid-suppressive drug use, and the duration of antibiotic use (P < 0.05). Logistic regression analysis showed that high APACHE II score, combined hypoproteinemia, fasting time before enteral nutrition ≥48 hours, enteral nutrition infusion rate ≥80 ml/h, and duration of antibiotic use ≥7 days were risk factors for ENAD in neurocritical care patients. Conclusion High APACHE II score, combined hypoproteinemia, fasting time before enteral nutrition ≥48 hours, enteral nutrition infusion rate ≥80 ml/h, and duration of antibiotic use ≥7 days are risk factors for ENAD in neurocritical care patients. The constructed nomogram can accurately predict the risk of ENAD occurrence.