关键词: 颅内占位, 营养不良, 预测模型, 儿童

Abstract:

Objective To construct and validate a risk prediction model for postoperative malnutrition in children with intracranial space-occupying lesions, in order to identify high-risk children at an early stage, formulate targeted nutritional support plans, reduce the incidence of postoperative malnutrition, and improve the prognosis of children. Methods By using the convenience sampling method, 167 children with intracranial space-occupying lesions who were scheduled to undergo surgical treatment at Hunan Children's Hospital from March 2020 to November 2023 were selected as the research subjects. Among them, 117 cases were taken as the modeling group and 50 cases as the validation group. The general information of the child patients, disease-related information, and information related to treatment and nursing were retrospectively collected. A risk prediction model was constructed through single-factor analysis and Logistic regression analysis, and a nomogram was drawn. The predictive efficacy of the model was evaluated using the receiver operating characteristic (ROC) curve, and the fitting effect of the model was evaluated using the Hosmer-Lemeshow test. Results The incidence of postoperative malnutrition in children with intracranial space-occupying lesions was 34.13%(57/167). Logistic regression analysis showed that preoperative risk of malnutrition, whether complications occurred after surgery, whether nutritional support was received during the perioperative period, pediatric critical illness score, anemia, serum albumin level and C-reactive protein level were independent influencing factors of postoperative malnutrition (P<0.05). The area under the ROC curve of the constructed risk prediction model in the modeling group was 0.863 (95%CI: 0.789-0.906), and the Hosmer-Lemeshow test P=0.679, indicating a good fitting effect. In the validation group, the area under the ROC curve of the model was 0.876 (95%CI: 0.823-0.927), the sensitivity was 0.735, and the specificity was 0.768. The validation results were good. Conclusion The risk prediction model for postoperative malnutrition in children with intracranial space-occupying lesions constructed in this study has good predictive efficacy and fitting effect. It can provide a reference basis for medical staff to identify high-risk children at an early stage and formulate personalized nutritional support plans, which is helpful to reduce the incidence of postoperative malnutrition and improve the prognosis of children.

Key words: Intracranial space occupation, Malnutrition, Prediction model, Child