Evaluation of clinical outcomes with the modified nutritional risk score in critically Ill patients

Authors : Gökçenur Yurtkulu, Turan Evran, Hülya Sungurtekin

Pages : 138-145

Doi:10.32322/jhsm.1601482

View : 43 | Download : 81

Publication Date : 2025-01-12

Article Type : Research Paper

Abstract :Aims: Our aim in this study was to evaluate the effectiveness of the modified nutrition risk score (mNUTRIC) score in predicting clinical outcomes and mortality in patients admitted to intensive care units (ICUs). Methods: This study was designed as a prospective observational cohort study. It was conducted in patients admitted to the Anesthesiology and Reanimation ICUs of Pamukkale University Hospital. The primary outcome measure of this study was the comparison of mNUTRIC scores at days 2, 7, and 12 between survivors and non-survivors. Secondary outcome measures included the effectiveness of predicting the necessity for invasive mechanical ventilation (IMV), hemodialysis, and vasopressor or inotropic support. Additionally, the study examined the impact of nutritional adequacy (categorized as hypocaloric or hypercaloric) and protein intake levels (classified as low, medium and high) on mortality among patients. Student’s T test or Mann-Whitney U test was used for comparisons involving continuous variables, and the Chi-square test was used for categorical variables. Results: The mNUTRIC scores of 176 patients who participated in the study were meticulously assessed. In this context, mNUTRIC scores were computed for the entirety of the patient cohort (n=176) on the second day for 91 patients on the seventh day, and for forty-six patients on the twelfth day on the second day the APACHE II, SOFA, and mNUTRIC scores exhibited significantly elevated values in patients who succumbed to their conditions (22.60±7.94, 6.81±3.03, and 5.00±2.03) in contrast to those who survived (16.99±5.05, 3.94±2.26, and 3.32±1.48, all p<0.001). On the seventh day these scores persisted at heightened levels in deceased patients (24.38±7.07, 6.82±3.52, and 5.00±1.61) relative to survivors (18.06±4.70, 3.85±2.10, and 3.50±1.58, all p<0.001). On the twelfth day the APACHE II, SOFA, and mNUTRIC scores recorded were 25.61±7.18, 7.00±3.57, and 5.52±1.81 for patients who did not survive, whereas survivors had scores of 18.70±5.88, 4.39±1.75, and 3.39±2.02 (p=0.001, p=0.008, p<0.001, respectively). Conclusion: Statistically significant differences were observed in the APACHE II, SOFA, and mNUTRIC scores on days 2, 7, and 12 between surviving and deceased patients. However, it was observed that nutritional adequacy and protein intake were not determinants that directly affected the mortality risk in critically ill patients with high mNUTRIC scores.
Keywords : mNUTRIC, yoğun bakım ünitesi, mortalite, morbidite, puanlama sistemi