Assessing nutritional risk and its association with mortality in ICU patients using the modified NUTRIC score: evidence from a tertiary care hospital.
The mNUTRIC score is associated with mortality in ICU patients, with low nutritional risk linked to lower odds of death.
Where it sits
this study against the rest of the melanotan ii corpusSummary and findings
This study assessed nutritional risk in ICU patients using the modified NUTRIC score and evaluated its association with in-hospital mortality. A total of 584 ICU patients were included, with a mean age of 57.6 years and 67.5% being female. High nutritional risk was associated with a mortality rate of 62.9%.
Abstract
<h4>Background</h4>The objective of this study was to assess nutritional risk in ICU patients using the modified Nutritional Risk in Critically ill (mNUTRIC) score and to evaluate its association with in-hospital mortality.<h4>Methods</h4>A cross-sectional study was conducted in a tertiary care hospital, including 584 ICU admitted patients. The mNUTRIC score was calculated, and the association between mNUTRIC-defined nutritional risk and mortality was evaluated using logistic regressions.<h4>Results</h4>Of the total 584 patients, the mean 57.6 ± 15.3 years and 67.5% (<i>n</i> = 394) were female. The mean APACHE-II and SOFA scores were 18.9 ± 8.5 and 5.1 ± 1.9, respectively. The mean mNUTRIC score was 3.2 ± 2.0 with 69.9% of patients classified as low nutritional risk and 30.1% as high nutritional risk. Patients classified as having high nutritional risk by the mNUTRIC score had a high mortality rate (62.9%). In adjusted mortality model, low nutritional risk based on the mNUTRIC score was associated with significantly lower odds of mortality (aOR 0.51, 95% CI 0.28-0.91) after adjustment for APACHE-II score, the number of comorbidities, and ICU type. The area under the curve for discriminating mortality was 0.819.<h4>Conclusion</h4>The mNUTRIC score is a useful nutritional risk screening tool and demonstrates a strong prognostic association with mortality in critically ill ICU patients, supporting its applicability in a tertiary care hospital context in Pakistan.
Background
This paper addresses the clinical question of nutritional risk assessment in ICU patients and its potential impact on mortality. Prior knowledge indicated that nutritional risk is a significant factor in critically ill patients, but specific tools like the mNUTRIC score had not been extensively validated in certain populations. This study aims to fill that gap by evaluating the mNUTRIC score's association with mortality in a tertiary care setting.
Methods
A cross-sectional study was conducted involving 584 ICU patients. The mNUTRIC score was calculated for each patient, and logistic regression analyses were used to evaluate the association between nutritional risk and mortality. No specific duration or route of intervention was reported.
Results
The primary endpoint indicated that patients classified as having high nutritional risk had a mortality rate of 62.9%. The adjusted odds ratio for low nutritional risk associated with mortality was 0.51 (95% CI 0.28-0.91), suggesting a significant association after adjusting for confounding factors.
Interpretation
The findings suggest that the mNUTRIC score is a useful tool for predicting mortality in ICU patients, with a statistically significant association. However, the effect size may not be clinically meaningful for all practitioners, especially given the high mortality rate in the high-risk group. Limitations include the study's cross-sectional design and its single-site nature, which may restrict broader applicability.
Key findings
- Mean age 57.6 ± 15.3 years, n=584.
- 67.5% (n=394) were female.
- Mean mNUTRIC score was 3.2 ± 2.0.
- 30.1% classified as high nutritional risk.
- Mortality rate in high nutritional risk group was 62.9%.
- Adjusted odds ratio for low nutritional risk associated with mortality was 0.51 (95% CI 0.28-0.91).
Limitations
- Cross-sectional design limits causal inference.
- Single-site study may affect generalizability.
- No specific duration of follow-up reported.
- Potential confounding factors not fully controlled.