Significance of the Modified NUTRIC Score for Predicting Clinical Outcomes in Patients with Severe Community-Acquired Pneumonia

Tseng, Chia‐Cheng; Tu, Chih‐Yen; Chen, Chia-Hung; Chen, Wei Chih; Fu, Pin-Kuei; Chen, Chin-Ming; Lai, Chih‐Cheng; Kuo, Li‐Kuo; Ku, Shih-Chi; Fang, Wen‐Feng

doi:10.3390/nu14010198

Cited by 15 publications

(10 citation statements)

References 57 publications

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“…Regarding the NUTRIC and mNUTRIC in severe COVID-19 requiring ICU admission, all reports were concordant, suggesting that higher scores accurately predict higher mortality [ 38 , 39 , 40 , 41 ]. Furthermore, there is evidence that mNUTRIC effectively predicts mortality in other clinical entities associated with acute respiratory failure, such as community-acquired pneumonia [ 42 ]. Our findings follow the same trendline, as deceased patients had significantly higher NUTRIC and mNUTRIC scores.…”

Section: Discussionmentioning

confidence: 99%

Nutritional Risk Assessment Scores Effectively Predict Mortality in Critically Ill Patients with Severe COVID-19

et al. 2022

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Background: Malnutrition predicts a worse outcome for critically ill patients. However, quick, easy-to-use nutritional risk assessment tools have not been adequately validated. Aims and Methods: The study aimed to evaluate the role of four biological nutritional risk assessment instruments (the Prognostic Nutritional Index—PNI, the Controlling Nutritional Status Score—CONUT, the Nutrition Risk in Critically Ill—NUTRIC, and the modified NUTRIC—mNUTRIC), along with CT-derived fat tissue and muscle mass measurements in predicting in-hospital mortality in a consecutive series of 90 patients hospitalized in the intensive care unit for COVID-19-associated ARDS. Results: In-hospital mortality was 46.7% (n = 42/90). Non-survivors had a significantly higher nutritional risk, as expressed by all four scores. All scores were independent predictors of mortality on the multivariate regression models. PNI had the best discriminative capabilities for mortality, with an area under the curve (AUC) of 0.77 for a cut-off value of 28.05. All scores had an AUC above 0.72. The volume of fat tissue and muscle mass were not associated with increased mortality risk. Conclusions: PNI, CONUT, NUTRIC, and mNUTRIC are valuable nutritional risk assessment tools that can accurately predict mortality in critically ill patients with COVID-19-associated ARDS.

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Section: Discussionmentioning

confidence: 99%

Nutritional Risk Assessment Scores Effectively Predict Mortality in Critically Ill Patients with Severe COVID-19

et al. 2022

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“…The recent guidelines from the American Society for Parenteral and Enteral Nutrition (ASPEN) recommend classifying nutritional risk using assessment tools such as Nutrition Risk Screening 2002 (NRS 2002), the Malnutrition Universal Screening Tool (MUST), the Nutrition Risk in the Critically Ill score (NUTRIC), or its modi ed version (mNUTRIC), to ascertain baseline nutritional status and to inform individualized nutritional management 4 . The mNUTRIC, widely used and validated across numerous clinical studies, correlates with clinical outcomes including mortality and adverse events in the intensive care unit [16][17][18] . In critically ill patients with high nutritional risk, indicated by an mNUTRIC score of ≥ 5, previous studies have demonstrated the bene ts of early caloric supplementation-providing higher energy and protein-in terms of reducing mortality and morbidity [19][20][21][22] .…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Peptide-Based versus Standard Polymeric Enteral Nutrition in ICU Patients at High Nutritional Risk: A Multicenter Randomized Controlled Trial

Bhurayanontachai,

Wacharasint,

Somboonviboon

et al. 2024

Preprint

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Introduction: Within intensive care units (ICU), the administration of peptide-based formulas (PBF) may confer nutritional advantages for critically ill patients identified with heightened nutritional risk. This investigation aimed to ascertain the efficacy of PBF in comparison to standard polymeric formulas (SPF) among this patient cohort. Methods A double-blind, randomized controlled trial was conducted across three ICUs, encompassing 63 adult patients characterized by elevated modified Nutrition Risk in Critically Ill (mNUTRIC) scores. Enrollment occurred promptly subsequent to ICU admission, with participants allocated to receive either PBF or SPF. Primary outcome was the duration to achieve caloric targets. Secondary outcomes involved the evaluation of mean daily gastric residual volume, mechanical ventilation period, infection rates within the ICU, length of hospitalization, mortality rates, nutritional status and inflammatory markers, specifically serum albumin and interleukin-6 levels. Results Patients in the PBF group reached their caloric targets more expeditiously compared to the SPF group (2.06 ± 0.43 days versus 2.39 ± 0.79 days; p = 0.03). No significant differences were discernible between the groups regarding gastric residual volume, duration of mechanical ventilation, ICU length of stay, mortality, or infection rates. Both cohorts exhibited minimal adverse effects and were devoid of any instances of abdominal distension. While not reaching statistical significance, the observed trends in albumin and interleukin-6 levels suggest a potential advantage of PBF utilization. Conclusions The implementation of PBF enabled swifter attainment of caloric goals in ICU patients at high nutritional risk without adversely impacting other clinical parameters. Given its favorable tolerance profile and potential immunomodulatory properties, PBF may be considered a valuable nutritional intervention in this setting. Trial Registration Thai Clinical Trials Registry TCTR20220221006. Registered 21 February 2022, https://www.thaiclinicaltrials.org/show/TCTR20220221006

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“… 3 A modified version of the NUTRIC score, which includes all factors used to calculate the NUTRIC score except for serum interleukin-6 (IL-6) concentration, has also been reported to predict clinical outcomes in various groups of critically ill patients. 4 – 9 …”

Section: Introductionmentioning

confidence: 99%

Ability of the modified NUTRIC score to predict mortality in patients requiring short-term versus prolonged acute mechanical ventilation: a retrospective cohort study

Yoo,

Jang,

Seong

et al. 2024

Ther Adv Respir Dis

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Background: The modified NUTRIC (nutritional risk in the critically ill) score has been reported to predict clinical outcomes in critically ill patients. However, the applicability of this score may differ between patients undergoing short-term mechanical ventilation (STMV, < 96 h) and those undergoing prolonged acute mechanical ventilation (PAMV, ⩾96 h), as PAMV patients typically experience significantly higher morbidity and mortality. Objective: This study aimed to investigate the predictive ability of modified NUTRIC score for predicting 28-day mortality in patients receiving STMV and PAMV. Design: Retrospective single-center cohort study. Methods: We enrolled patients who received mechanical ventilation (MV) on the day of admission to the intensive care unit (ICU) from 1 December 2015 to 30 November 2020. Modified NUTRIC scores were calculated based on the clinical data of each patient at ICU admission. Results: The study population comprised 464 patients, including 319 (68.8%) men with a mean age of 69.7 years. Among these patients, 132 (28.4%) received STMV and 332 (71.6%) received PAMV. The overall 28-day mortality rate was 26.7%, which was significantly higher in STMV patients than in PAMV patients (37.9% versus 22.3%, p < 0.001). Evaluation of the predictive performance of the modified NUTRIC score for 28-day mortality revealed areas under the receiver operating characteristic curves of 0.672 [95% confidence interval (CI): 0.627–0.714] for total patients, 0.819 (95% CI, 0.742–0.880) for STMV patients, and 0.595 (95% CI, 0.540–0.648) for PAMV patients. The best overall cutoff value was 5 in total, STMV, and PAMV patients. This cutoff value was a significant predictor of 28-day mortality based on the Cox proportional hazard model for total [hazards ratio (HR): 2.681; 95% CI: 1.683–4.269] and STMV (HR: 5.725; 95% CI: 2.057–15.931) patients, but not for PAMV patients. Conclusion: The modified NUTRIC score is more effective in predicting 28-day mortality in patients undergoing STMV than in those undergoing PAMV.

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Significance of the Modified NUTRIC Score for Predicting Clinical Outcomes in Patients with Severe Community-Acquired Pneumonia

Cited by 15 publications

References 57 publications

Nutritional Risk Assessment Scores Effectively Predict Mortality in Critically Ill Patients with Severe COVID-19

Nutritional Risk Assessment Scores Effectively Predict Mortality in Critically Ill Patients with Severe COVID-19

Comparative Efficacy of Peptide-Based versus Standard Polymeric Enteral Nutrition in ICU Patients at High Nutritional Risk: A Multicenter Randomized Controlled Trial

Ability of the modified NUTRIC score to predict mortality in patients requiring short-term versus prolonged acute mechanical ventilation: a retrospective cohort study

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