A prediction model of enteral nutrition complicated with severe diarrhea in ICU patients based on CD55.

Abstract

Severe diarrhea is a common complication of enteral nutrition in intensive care unit (ICU) patients. CD55 not only plays a vital role in immune but also plays a crucial role in intestinal function. We intended to build a prediction model of enteral nutrition complicated with severe diarrhea in ICU patients based on CD55. This was a prospective, single-center, observational study. We collected 116 patients with enteral nutrition in the ICU. We collected blood samples from patients at the time of admission, tested blood biomarkers [CD55, interleukin-10 (IL-10), diamine oxidase, D-lactic acid and endotoxin], and recorded daily defecation and enteral nutrition. Finally, through multi-factor logistic regression model, a prediction model based on multiple prediction indicators was formed, and new joint predictive factors were calculated. The prediction model of enteral nutrition complicated with severe diarrhea in ICU patients was constructed through data processing analysis. A total of 116 adult patients with enteral nutrition were divided into two groups: 77 patients without severe diarrhea and 39 with severe diarrhea. Compared with patients without severe diarrhea, CD55 on granulocyte membrane surface(gCD55) of patients with severe diarrhea was significantly reduced (P<0.0001), and CD55 on erythrocyte membrane surface(eCD55) of patients with diarrhea was significantly reduced (P<0.0001), serum IL-10 in patients with diarrhea significantly decreased compared with those without diarrhea, P<0.0001.The area under the curve of receiver operating characteristic (AUCROC) was 0.919 in gCD55 predicting severe diarrhea, when cutoff value =99.95%, the optimal sensitivity was 96.2%, and specificity was 100%. The AUROC of eCD55 and IL-10 in predicting severe diarrhea was 0.658 and 0.558 respectively. Based on this, a prediction model was established. The prediction model was: In[P/(1- P)] =-24.68 gCD55 -2.26 eCD55 +0.0041 IL-10 +2,691, the goodness of fit test of the model was P=0.44, and the AUCROC of the model was 0.92. gCD55 and eCD55 had certain predictive value in enteral nutrition complicated with severe diarrhea.