Kumar Neeraj, Kumar Abhyuday, Kumar Ajeet, Pattanayak Arunima, Singh Kunal, Singh Prabhat K
Department of Trauma and Emergency, All India Institute of Medical Sciences, Patna, Bihar, India.
Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar, India.
Indian J Anaesth. 2021 Sep;65(9):669-675. doi: 10.4103/ija.ija_474_21. Epub 2021 Oct 8.
The Nutrition Risk in Critically ill (NUTRIC) score is an appropriate nutritional assessment tool in mechanically ventilated patients. We retrospectively observed the applicability of the NUTRIC score for predicting outcomes in coronavirus disease (COVID)-19 acute respiratory distress syndrome (ARDS) patients.
All adult COVID-19 ARDS patients admitted to the intensive care unit and requiring various forms of oxygen therapy were included in the study. The demographic characteristics and clinical information about the patients were obtained from the hospital's medical records department. The nutritional risk for each patient was assessed using the NUTRIC score at 72 hours of ICU admission. The discriminating power and ability of NUTRIC score, Sequential Organ Failure Assessment (SOFA) score, age and Acute Physiology and Chronic Health Evaluation (APACHE) II to predict the 28-day mortality and need for mechanical ventilation (MV) was calculated using receiver operating characteristic curves and area under this curve.
A total of 80 COVID-19 ARDS patients fitted into the inclusion criteria. Among non-survivors, the median Glasgow Coma Score, APACHE II score, NUTRIC score and SOFA score were 10, 16, 6 and 4, respectively. The cut-off values for NUTRIC score, SOFA, and APACHE II to predict 28-day mortality and need for MV was obtained as 3.5, 3.5 and 11.5, respectively. These cut-off values of NUTRIC score, SOFA score, and APACHE II have a sensitivity of 62%, 72.5% and 75.5%, respectively, and specificity of 95%, 72% and 83% for predicting mortality.
Most COVID-19 ARDS patients requiring MV in the ICU are at nutritional risk, and a high NUTRIC score is associated with higher mortality.
危重症营养风险（NUTRIC）评分是机械通气患者适用的营养评估工具。我们回顾性观察了NUTRIC评分在预测冠状病毒病（COVID）-19急性呼吸窘迫综合征（ARDS）患者预后方面的适用性。
纳入所有入住重症监护病房且需要各种形式氧疗的成年COVID-19 ARDS患者。患者的人口统计学特征和临床信息从医院病历部门获取。在入住重症监护病房72小时时使用NUTRIC评分评估每位患者的营养风险。使用受试者工作特征曲线及曲线下面积计算NUTRIC评分、序贯器官衰竭评估（SOFA）评分、年龄和急性生理与慢性健康状况评估（APACHE）II预测28天死亡率和机械通气（MV）需求的鉴别能力。
共有80例COVID-19 ARDS患者符合纳入标准。在非幸存者中，格拉斯哥昏迷评分、APACHE II评分、NUTRIC评分和SOFA评分的中位数分别为10、16、6和4。NUTRIC评分、SOFA评分和APACHE II预测28天死亡率和MV需求的临界值分别为3.5、3.5和11.5。这些NUTRIC评分、SOFA评分和APACHE II的临界值预测死亡率的敏感性分别为62%、72.5%和75.5%，特异性分别为95%、72%和83%。
大多数在重症监护病房需要机械通气的COVID-19 ARDS患者存在营养风险，高NUTRIC评分与较高死亡率相关。
