Construction and evaluation of a nomogram model for prediction of enteral nutrition intolerance in patients with severe traumatic brain injury
WEI Jie
ZHANG Ning
LI Xin-hao
WANG Xi-wang
LI Ke-fen
ZHU Xu
Abstract：Objective To investigate the risk factors of enteral feeding intolerance(EFI)during the enteral nutrition treatment for patients with severe traumatic brain injury(sTBI),and subsequently establish and validate a nomogram prediction model.Methods The clinical data of 170 patients with sTBI admitted from January 2019 to January 2023 were retrospectively analyzed.Results Enteral nutrition was administered within 48 hours of admission,and 52 patients developed EFI,with an incidence rate of 30.6%(52/170).Multivariate logistic regression analysis indicated that older age,prolonged ICU stay,hypokalemia,hyperglycemia,lower GCS score,mechanical ventilation,and the use of analgesic and sedative drugs were independent risk factors for EFI during enteral nutrition in patients with sTBI(P<0.05).A nomogram model was established using the R software,and the area under the curve of ROC was 0.8659(95%CI 0.8072～0.9246),with a sensitivity of 90.39%and a specificity of 66.95%.The calibration curve was largely overlapping with the ideal curve,and the Hosmer-Lemeshow goodness-of-fit test demonstrated a high degree of model ideality.Decision curve analysis revealed that when the threshold probability range was 0.10～0.95,the model exhibited a positive net benefit,with a wide threshold range,suggesting a high clinical practical value and benefit.Conclusion The nomogram model based on patient age,ICU stay,blood potassium level,blood glucose level,GCS score,mechanical ventilation,and the use of analgesic and sedative drugs for predicting EFI during enteral nutrition in patients with sTBI has high accuracy and practicality.
Keywords：Severe traumatic brain injuryEnteral feeding intoleranceRisk factorsNomogram model
Publication Date：2024-10-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 599-604,607 )