Confirming the validity of the CONUT system for early detection and monitoring of clinical undernutrition: comparison with two logistic regression models developed using SGA as the gold standard
Confirming the validity of the CONUT system for early detection and monitoring of clinical undernutrition: comparison with two logistic regression models developed using SGA as the gold standard
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DOI：
10.1590/s0212-16112012000200033
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发表时间：
2012-04-01
期刊：
影响因子：
--
通讯作者：
de Ulibarri, J. I.
中科院分区：
文献类型：
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作者：
González-Madroño, A.;Mancha, A.;de Ulibarri, J. I.
目的：为了批准以前的验证CONUT营养筛查工具的两个概率模型的发展，使用包括在CONUT的参数，看看CONUT的有效性可以提高。在第1步中，随机选择101例患者，进行SGA和CONUT。根据获得的数据，开发了一个非条件logistic回归模型，并构建了CONUT的两个变体：模型1是通过logistic回归方法制作的。模型2是通过将模型1中获得的营养不良概率划分为七个有规律的间隔而形成的。在第2步中，选择了60名患者，并接受了SGA、原始CONUT和开发的新模型。用ROC曲线检验原CONUT模型和新模型的诊断效能。将样本1和样本2放在一起，衡量原始CONUT和SGA的一致程度，并计算诊断功效参数。结果：样本1和样本2在年龄、性别和内科/手术分布方面无统计学差异，营养不良率相似（均在40%以上）。原始CONUT的ROC曲线的AUC为0.862，模型1和2分别为0.839和0.874。CONUT与SGA的Kappa指数为0.680。结论：CONUT与作者指定的原始评分一样好于数学模型，因此是一种有价值的工具，非常有用和有效的临床营养不良筛查的目的。(Nutr 2012;27：564-571）DOI：10.3305/nh.2012.27.2.5630
Aim: To ratify previous validations of the CONUT nutritional screening tool by the development of two probabilistic models using the parameters included in the CONUT, to see if the CONUT's effectiveness could be improved.Methods: It is a two step prospective study. In Step 1, 101 patients were randomly selected, and SGA and CONUT was made. With data obtained an unconditional logistic regression model was developed, and two variants of CONUT were constructed: Model 1 was made by a method of logistic regression. Model 2 was made by dividing the probabilities of undernutrition obtained in model 1 in seven regular intervals. In step 2, 60 patients were selected and underwent the SGA, the original CONUT and the new models developed. The diagnostic efficacy of the original CONUT and the new models was tested by means of ROC curves. Both samples 1 and 2 were put together to measure the agreement degree between the original CONUT and SGA, and diagnostic efficacy parameters were calculated.Results: No statistically significant differences were found between sample 1 and 2, regarding age, sex and medical/surgical distribution and undernutrition rates were similar (over 40%). The AUC for the ROC curves were 0.862 for the original CONUT, and 0.839 and 0.874, for model 1 and 2 respectively. The kappa index for the CONUT and SGA was 0.680.Conclusions: The CONUT, with the original scores assigned by the authors is equally good than mathematical models and thus is a valuable tool, highly useful and efficient for the purpose of Clinical Undernutrition screening. (Nutr Hosp. 2012;27:564-571) DOI:10.3305/nh.2012.27.2.5630