Construction and validation of a predictive model for the risk of feeding intolerance to enteral nutrition therapy in HIV/AIDS patients

GONG Beibei; HUANG Haimei; WEI Caiyun; YU Mingliu; HE Huawei

doi:10.12173/j.issn.1004-5511.202401109

Abstract：Objective To investigate the influencing factors of enteral nutrition therapy intolerance in HIV/AIDS patients,establish and validate a Nomogram model.Methods A retrospective analysis was conducted on the clinical data of hospitalized HIV/AIDS patients admitted to the Fourth people's Hospital of Nanning,from January 1,2015 to September 30,2021.Through the binary Logistic regression model,the risk factors for feeding intolerance in HIV/AIDS patients were explored,a Nomogram model was constructed and validated.Results A total of 174 HIV/AIDS patients were included,among which 76 patients experienced early enteral nutrition feeding intolerance(43.68％).Multivariate analysis showed that mean arterial pressure ≤ 80 mmHg[OR=2.822,95％CI(1.267,6.287)],Acute Physiology and Chronic Health Status Score Ⅱ＞15 points[OR=5.625,95％CI(1.435,22.048)],mechanical ventilation application[OR=5.459,95％CI(2.046,14.564)],highly active anti-retroviral therapy[OR=2.428,95％CI(1.118,5.275)],muscle relaxant use[OR=3.833,95％CI(1.758,8.357)],CD4+T cell count ≤200·μL-1[OR=3.785,95％CI(1.126,12.724)],the number of antibiotics used＞2[OR=2.365,95％CI(1.039,5.384)]were influential factors of feeding intolerance in enteral nutrition therapy in HIV/AIDS patients.A nomogram prediction model was constructed,the model AUC value was 0.849[95％CI(0.794,0.905)],with the maximum Youden index of 0.555.The optimal threshold was 0.331.The sensitivity was 88.16％,and the specificity was 67.35％.The calibration curve and decision curve indicated good consistency and benefit of the model.Conclusion The prediction model for the risk of enteral nutrition therapy intolerance in HIV/AIDS patients constructed in this study can provide a reference for medical staff to quickly identify the risk of feeding intolerance in HIV/AIDS patients and take preventive nursing measures in time.