Comparison of mNUTRIC-S2 and mNUTRIC scores to assess nutritional risk and predict intensive care unit mortality

Abstract

Background: Nutritional status is associated with mortality. The modified Nutrition Risk in the Critically Ill (mNUTRIC) score is one of the most commonly used nutritional risk assessment tools in intensive care units (ICUs). The purpose of this study was to compare the mortality predictive ability of the mNUTRIC score to that of the mNUTRIC-S2 score, which uses the Simplified Acute Physiology Score (SAPS) II instead of the Acute Physiology and Chronic Health Evaluation (APACHE) II. Methods: This retrospective cohort analysis included patients admitted to the ICU between January and September 2020. Each patient's electronic medical records were reviewed. The model discrimination for predicting ICU mortality was assessed by the area under the receiver operating characteristic (ROC) curve, and a Cox regression model was performed to confirm the relationship between the groups and mortality. Results: In total, 220 patients were enrolled. The ROC curve for predicting ICU mortality was 0.64 for the mNUTRIC score versus 0.67 for the mNUTRIC-S2 score. The difference between the areas was 0.03 (95% confidence interval [CI], -0.01 to 0.06; P=0.09). Patients with mNUTRIC-S2 score ≥5 had a greater risk of ICU mortality (hazard ratio [HR], 3.64; 95% CI, 1.85-7.14, P<0.001); however, no such relationship was observed with mNUTRIC score (HR, 1.69; 95% CI, 0.62-4.62; P=0.31). Conclusions:The mNUTRIC-S2 score was significantly associated with ICU mortality. A cutoff score of 5 was selected as most appropriate.

Modified NUTRIC Score as a Predictor of All-cause Mortality in Critically Ill Patients: A Systematic Review and Meta-analysis

“…3, Table 1 displays the features of every included study that is a part of the current meta-analysis. Bias in the outcome measurement was low in 24 studies, 3, [13][14][15][16][17][18][19][22][23][24][25][26][27][29][30][31][32][33][34]36,[39][40][41][42][43] moderate in five studies, 20,28,35,37,38 and high risk of bias in two studies (Fig. 2).…”

Association of malnutrition status with 30-day mortality in patients with sepsis using objective nutritional indices: a multicenter retrospective study

“…Sepsis, in which the uncontrolled host reaction to infection results life-threatening organ dysfunction, is a major cause of morbidity and mortality worldwide [ 1 ]. Malnutrition is a factor that further exacerbates the severity and outcome of this disease, contributing to inadequate nutrient intake and being associated with immune dysfunction [ 2 ], inflammation [ 3 ], and increased mortality [ 4 ]. Recognizing the potential interplay between these two conditions, we sought to understand their combined impact on patient health by investigating the relationship between malnutrition markers and patient outcomes with the aim of improving care for this vulnerable patient population.…”