Complementarity of modified NUTRIC score with or without C-reactive protein and
            subjective global assessment in predicting mortality in critically ill patients

Oliveira, Manoela Lima; Heyland, Daren K.; Silva, Flávia Moraes; Rabito, Estela Iraci; Rosa, Mariane; Tarnowski, Micheli da Silva; Fernandes, Daieni; Marcadenti, Aline

doi:10.5935/0103-507x.20190086

Cited by 14 publications

(12 citation statements)

References 27 publications

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“…In this study, we found that the mNUTRIC score was a good prognostic predictor in critically ill patients and that high mNUTRIC scores were associated with an elevated risk of death at 28 days (HR = 1.085, 95% CI = 1.018 to 1.157, P = 0.012). This finding is consistent with those of prior studies [9,13,16].…”

Section: Discussionsupporting

confidence: 94%

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Association between the modified Nutrition Risk in Critically Ill (mNUTRIC) score and clinical outcomes in the intensive care unit: a secondary analysis of a large prospective observational study

Wang

Jiang

et al. 2021

BMC Anesthesiol

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Background Malnutrition in intensive care unit (ICU) patients is associated with adverse clinical outcomes. The modified nutrition risk in the critically ill score (mNUTRIC) was proposed as an appropriate nutritional assessment tool in critically ill patients, but it has not been fully demonstrated and widely used. Our study was conducted to identify the nutritional risk in ICU patients using the mNUTRIC score and explore the relationship between 28-day mortality and high mNUTRIC scores. Methods This study is a secondary analysis, the data were extracted from The Beijing Acute Kidney Injury Trial (BAKIT). In total, 9049 patients were admitted consecutively, and 3107 patients with complete clinical data were included in this study. We divided the study population into high nutritional risk (mNUTRIC score ≥ 5 points) and low nutritional risk (mNUTRIC score < 5 points) groups. The predictive capacity of the mNUTRIC score was studied by receiver operating characteristic (ROC) curve analysis, appropriate cut-off was identified by highest combined sensitivity and specificity using Youden’s index. The significance level was set at 5%. Results Among the 3107 patients, the 28-day mortality rate was 17.4% (540 patients died). Nearly 28.2% of patients admitted to the ICU were at risk of malnutrition, high nutritional risk patients were older (P < 0.001), with higher illness severity scores than low nutritional risk patients. Multivariate analysis revealed that the mNUTRIC score was an independent risk factor for 28-day mortality and mortality increased with increasing scores (p = 0.000). The calculated area under curve (AUC) for the mNUTRIC score was 0.763 (CI 0.740–0.786). According to Youden’s index, we found a suitable cut-off > 4 for the mNUTRIC score to predict the 28-day mortality. Conclusions Patients admitted to the ICU were at high risk of malnutrition, and a high mNUTRIC score was associated with increased ICU length of stay and higher mortality. More large prospective studies are needed to demonstrate the validity of this score. Trial registration This study was registered at www.chictr.org.cn (registration number Chi CTR-ONC-11001875). Registered on 14 December 2011.

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Section: Discussionsupporting

confidence: 94%

“…Some studies are available on the validity of the mNUTRIC score, however, most of them are small samples [9][10][11][12] or retrospective studies [13][14][15], and there are few prospective studies with large samples at present [8,16,17]. The mNUTRIC score has not been widely used in China, where has been no large sample studies.…”

Section: Introductionmentioning

confidence: 99%

Association between the modified Nutrition Risk in Critically Ill (mNUTRIC) score and clinical outcomes in the intensive care unit: a secondary analysis of a large prospective observational study

Wang

Jiang

et al. 2021

BMC Anesthesiol

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“…We revised the letter to the Editor about our study with high interest. ( 1 ) Please, find below are our comments.…”

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confidence: 99%

Reply to: Complementary of modified NUTRIC score with or without C-reactive protein and subjective global assessment in predicting mortality in critically ill patients

et al. 2021

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“…We have read the article “Complementarity of modified NUTRIC score with or without C-reactive protein and subjective global assessment in predicting mortality in critically ill patients” by Oliveira et al ( 1 ) with great interest. The authors found excellent agreement between the modified Nutrition Risk in the Critically Ill (NUTRIC) score and the NUTRIC with C-reactive protein (CRP) score; in addition, the combination of NUTRIC score and subjective global assessment was a good predictor of increased risk of death at 28 days.…”

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confidence: 99%

“…( 3 ) In critically ill patients, malnutrition is closely related to the underlying inflammatory state, and depleted body protein is a central consideration. ( 4 ) Within a solid and coherent physiopathological framework for reasoning about nutrition in such patients, dispensing with a widely available inflammatory biomarker (CRP) that has been validated for enhancing the value of the NUTRIC score would not be reasonable, particularly given that Oliveira et al ( 1 ) found that a higher risk of death at 28 days was better predicted using NUTRIC-CRP alone (hazard ratio - HR = 2.685; 95% confidence interval - 95%CI 1.423 - 5.064; p = 0.002) or in combination with malnutrition (HR = 4.112; 95%CI 1.738 - 9.727) than if CRP were not utilized (for mNUTRIC alone: HR = 1.827; 95%CI 1.029 - 3.244; p = 0.040; for mNUTRIC with malnutrition: HR = 2.167; 95%CI 1.029 - 4.563).…”

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confidence: 99%

To: Complementary of modified NUTRIC score with or without C-reactive protein and subjective global assessment in predicting mortality in critically ill patients

Moretti¹,

Rocchetti²

2020

Revista Brasileira De Terapia Intensiva

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Complementarity of modified NUTRIC score with or without C-reactive protein and subjective global assessment in predicting mortality in critically ill patients

Cited by 14 publications

References 27 publications

Association between the modified Nutrition Risk in Critically Ill (mNUTRIC) score and clinical outcomes in the intensive care unit: a secondary analysis of a large prospective observational study

Association between the modified Nutrition Risk in Critically Ill (mNUTRIC) score and clinical outcomes in the intensive care unit: a secondary analysis of a large prospective observational study

Reply to: Complementary of modified NUTRIC score with or without C-reactive protein and subjective global assessment in predicting mortality in critically ill patients

To: Complementary of modified NUTRIC score with or without C-reactive protein and subjective global assessment in predicting mortality in critically ill patients

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