The study aims to develop and validate a prognostic prediction model for adverse outcomes in neurocritical patients receiving enteral nutrition based on key inflammatory and metabolic markers. This model will serve as a clinical tool to help physicians identify high-risk patients and guide individualized nutritional support strategies.
A multi-center, prospective case data collection study will be conducted across 19 tertiary hospitals in China. Based on this, a predictive assessment model for poor prognosis in neurocritically ill patients receiving enteral nutrition support will be developed and validated, using key inflammatory and metabolic markers. During the data collection process, comprehensive clinical information will be extracted, including patient demographic data, clinical indicators, and hematological markers. By conducting in-depth analysis and processing of this vast and detailed clinical and laboratory data, a nomogram for predicting poor prognosis in neurocritical care patients receiving enteral nutrition support will be constructed using statistical methods and data analysis techniques in R. Once the model is built, it will undergo rigorous validation on an independent external dataset to ensure its accuracy and reliability. The goal is to create a precise assessment tool for clinicians, helping them to quickly and accurately identify high-nutritional-risk patients, thereby providing a solid scientific foundation for the formulation of individualized nutrition support strategies, ultimately improving the prognosis of neurocritical patients.
Study Type
OBSERVATIONAL
Enrollment
1,185
Beijing Hui People's Hospital
Beijing, Beijing Municipality, China
Xuanwu Hospital, Capital Medical University
All-cause mortality at Day 28 of enteral nutrition therapy
Time frame: From enrollment to 28 days after the initiation of enteral nutrition
Nutritional goal achievement rate at Day 3 (caloric and protein intake reaching 70%-100% of calculated target)
Time frame: At Day 3 after the initiation of enteral nutrition
Adverse outcome rate at Day 90 (defined as a Modified Rankin Scale score ≥ 3)
Time frame: At Day 90 after the initiation of enteral nutrition
Incidence of infectious complications within 14 days (including pneumonia, urinary tract infections, bloodstream infections, skin infections, and Clostridium difficile infections)
Time frame: Within 14 days after the initiation of enteral nutrition
Gastrointestinal intolerance within 14 days (gastric residual volume > 200 mL, nausea, vomiting, bloating, diarrhea)
The gastric residual volume is assessed every 4 hours by the nurse through aspiration via the nasogastric tube. Other clinical manifestations such as nausea, vomiting, bloating, and diarrhea are assessed through daily observation by the attending physician.
Time frame: Within 14 days after the initiation of enteral nutrition
Incidence of gastrointestinal bleeding within 14 days (gastric occult blood, fecal occult blood, hematemesis, melena, hematochezia)
Time frame: Within 14 days after the initiation of enteral nutrition
Number of days with random blood glucose > 10 mmol/L within 14 days
Time frame: Within 14 days after the initiation of enteral nutrition
Average daily insulin requirement within 14 days
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Beijing, Beijing Municipality, China
You'anmen Hospital
Beijing, Beijing Municipality, China
The Ninth Medical Center of Chinese PLA General Hospital
Beijing, Beijing Municipality, China
The 940th Hospital of Joint Logistics Support Force of Chinese PLA
Lanzhou, Gansu, China
Guizhou Provincial People's Hospital
Guiyang, Guizhou, China
Affiliated Hospital of Zunyi Medical University
Zunyi, Guizhou, China
Tangshan People's Hospital
Tangshan, Hebei, China
The First Hospital of Hebei Medical University
Shijiazhuang, Heibei, China
Inner Mongolia Autonomous Region People's Hospital
Hohhot, Inner Mongolia, China
...and 9 more locations
Time frame: Within 14 days after the initiation of enteral nutrition
Incidence of hypophosphatemia within 3 days
Time frame: Within 3 days after the initiation of enteral nutrition
Duration of mechanical ventilation within 14 days
Time frame: Within 14 days after the initiation of enteral nutrition
Length of NICU stay
Time frame: From enrollment to discharge from the NICU, up to 1 year.
Total hospital stay duration
Time frame: From enrollment to discharge, up to 1 year.
90-day readmission rate post-discharge
Time frame: Within 90 days after discharge