# Analysis of risk factors and construction of nomogram model for enteral nutrition-related diarrhea in ICU patients

## TL;DR

This study identifies risk factors for diarrhea caused by enteral nutrition in ICU patients and builds a predictive model to help identify high-risk individuals.

## Contribution

A novel nomogram model is developed to predict enteral nutrition-related diarrhea in ICU patients.

## Key findings

- The incidence of EN diarrhea in ICU patients was 29.85%.
- The nomogram model showed high predictive power with an AUC of 0.860.
- Risk factors included hypoproteinemia, abdominal surgery, and high EN infusion rates.

## Abstract

To analyze risk factors of enteral nutrition (EN) diarrhea in intensive care unit (ICU) patients and to construct nomogram model.

A retrospective analysis was conducted on 402 patients who received EN treatment in the ICU of Shanghai Blue Cross Brain Hospital from January 2022 to January 2025. They were divided into diarrhea group and non-diarrhea group based on the occurrence of EN diarrhea. We used univariate and multivariate logistic regression analysis to identify risk factors for EN diarrhea. Construct a nomogram model for the occurrence of EN diarrhea in ICU patients based on independent risk factors and conduct goodness of fit tests.

The incidence of EN diarrhea in ICU patients was 29.85% (120/402). Hypoproteinemia, abdominal surgery in the last five days, fasting time > 5 days, antibiotic use > 2 weeks, no gradual increase in EN preparations, oral potassium preparations, EN liquid infusion rate ≥ 100ml/h, albumin level ≥ 35g/L were identified as risk factors for EN diarrhea (p<0.05). Based on the above influencing factors, a nomogram model was constructed and internally validated using the Bootstrap method. The nomogram model basically fitted with the ideal model. ROC area under curve (AUC) was 0.860 (95% CI: 0.820-0.901), indicating a certain predictive value for EN diarrhea.

The nomogram model has high predictive power in predicting the risk of EN diarrhea in ICU patients. It is beneficial for screening high-risk patients and further adjusting nutritional therapy.