重症病人肠内营养相关性腹泻风险预测模型的系统评价

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Systematic review of risk prediction models for enteral nutrition-associated diarrhea in critically ill patients

Abstract Objective：To systematically analyze and evaluate the prediction models for enteral nutrition-associated diarrhea，in order to provide reference for the construction of a higher quality risk prediction model for enteral nutrition-associated diarrhea.Methods：Relevant literature was searched from CBM，WanFang Database，CNKI，EMbase，PubMed，CINAHL，Web of Science and the Cochrane Library.The retrieval time was from the inception to March 1，2024 in Chinese and English.Two researchers independently screened literature and extracted data，and prediction model risk of bias assessment tool（PROBAST） was used to evaluate the risk of bias and applicability of included studies.Results：A total of 6 studies on risk prediction model construction of enteral nutrition-associated diarrhea were included，and the area under the subject operating characteristic curve of 6 models ranged from 0.732 to 0.940，and the predictors with the highest frequency were fasting days，daily doses of nutrient solution，days of oral potassium preparations，and use of antibiotics.The overall adaptability was good，and the risk of bias was high.The bias was mainly due to the lack of appropriate data sources，insufficient sample size，insufficient attention to missing data，and lack of model performance evaluation.Conclusion：Current evidence shows that the risk of bias of nutrition-associated diarrhea risk prediction model is high，and it is in the developing stage.Future research should focus on the effectiveness of different risk assessment methods，and build a risk prediction model with low risk of bias，excellent prediction performance and in line with clinical practice in China.

Keywords  enteral nutrition；diarrhea；prediction model；systematic review；evidence-based nursing

摘要  目的：对肠内营养相关性腹泻的风险预测模型进行系统检索和评价，以期为构建更高质量的肠内营养相关性腹泻风险预测模型提供参考。（剩余10779字）