Use of 3 Tools to Assess Nutrition Risk in the Intensive Care Unit

Coltman, A.; Peterson, Sarah J.; Roehl, Kelly; Roosevelt, Hannah; Sowa, D.

doi:10.1177/0148607114532135

Cited by 91 publications

(78 citation statements)

References 13 publications

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“…Most of the critically ill patients admitted to the ICU show malnutrition criteria [20]. Critical illness is typically associated with a catabolic stress state, skeletal muscle weakness, and as consequence with complications such as increased infectious morbidity, multiple-organ dysfunction, difficult weaning, prolonged hospitalization, and increased mortality.…”

Section: Discussionmentioning

confidence: 99%

Nutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients—A multicenter prospective cohort study

Mendes

Policarpo²,

Fortuna

et al. 2017

Journal of Critical Care

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a b s t r a c t a r t i c l e i n f o Keywords:Critically ill Nutritional risk Modified NUTRIC score Effectiveness Cultural validation Purpose: Characterize the nutritional risk of critically ill patients with the modified NUTrition Risk in the Critically ill (NUTRIC) score. Materials: National, multicenter, prospective, observational study conducted in 15 polyvalent Portuguese intensive care unit (ICU), during 6 months. Adult patients were eligible. Those transferred from another ICU or readmitted, brain dead at admission, and with length of ICU stay (LOS) of 72 hours or less were excluded. NUTRIC score was calculated at admission; scores ≥5 represent a high nutritional risk. Main outcome was mortality from all causes at 28 days after admission to the ICU; LOS and days without mechanical ventilation (days free of MV) were secondary outcomes. Results: From 2061 admissions, 1143 patients were considered, mostly males (n = 744, 64.7%) with median (P 25 -P 75 ) age of 64 (51-75). Patients at high nutritional risk were 555 (48.6%). High NUTRIC score was associated with longer LOS (P b .001), less days free of MV (P = .002) and higher 28-day mortality (P b .001). The area under the curve of NUTRIC score ≥5 for predicting 28-day mortality was 0.658 (95% CI, 0.620-0.696). NUTRIC score ≥5 had a positive predictive value 32.7% and a negative predictive value 88.8% for 28-day mortality. Conclusions: Almost half of the patients in Portuguese ICUs are at high nutritional risk. NUTRIC score was strongly associated with main clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Nutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients—A multicenter prospective cohort study

Mendes

Policarpo²,

Fortuna

et al. 2017

Journal of Critical Care

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“…Nutritional status can be evaluated by using tools such as the Subjective Global Assessment [2223], the Mini Nutritional Assessment [24], and the Malnutrition Clinical Characteristics [25] tools. Previous research has validated these scoring systems, but these tools typically cannot be used in patients un-dergoing emergency operations.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation

et al. 2016

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PurposeAn intestinal perforation is a rare condition, but has a high mortality rate, even after immediate surgical intervention. The clinical predictors of postoperative morbidity and mortality are still not well established, so this study attempted to identify risk factors for postoperative morbidity and mortality after surgery for an intestinal perforation.MethodsWe retrospectively analyzed the cases of 117 patients who underwent surgery for an intestinal perforation at a single institution in Korea from November 2008 to June 2014. Factors related with postoperative mortality at 1 month and other postoperative complications were investigated.ResultsThe mean age of enrolled patients was 66.0 ± 15.8 years and 66% of the patients were male. Fifteen patients (13%) died within 1 month after surgical treatment. Univariate analysis indicated that patient-related factors associated with mortality were low systolic and diastolic blood pressure, low serum albumin, low serum protein, low total cholesterol, and high blood urea nitrogen; the surgery-related factor associated with mortality was feculent ascites. Multivariate analysis using a logistic regression indicated that low systolic blood pressure and feculent ascites independently increased the risk for mortality; postoperative complications were more likely in both females and those with low estimated glomerular filtration rates and elevated serum C-reactive protein levels.ConclusionVarious factors were associated with postoperative clinical outcomes of patients with an intestinal perforation. Morbidity and mortality following an intestinal perforation were greater in patients with unstable initial vital signs, poor nutritional status, and feculent ascites.

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“…However, for the patients in intensive care units, to use only SGA or even Nutrition Risk in Critically ill score could be inappropriate, as they would not uniformly identify patients as malnourished. Hence, it would be useful to include physical assessment and functional tests to better predict nutrition risk in these patients (43). A Spanish study found that almost 63.3% of patients admitted to hospital were malnourished as assessed by SGA, but in the same time, another score, Instant Nutritional Assessment was the best single score to identify patients with/or at risk of malnutrition (44).…”

Section: Discussionmentioning

confidence: 99%