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NUTRIC 评分作为预测脓毒症重症监护患者死亡率和增加资源利用的工具。

The NUTRIC Score as a Tool to Predict Mortality and Increased Resource Utilization in Intensive Care Patients with Sepsis.

机构信息

Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, 50-556 Wroclaw, Poland.

Department of Anesthesiology and Intensive Therapy, Wroclaw University Hospital, 50-556 Wroclaw, Poland.

出版信息

Nutrients. 2023 Mar 28;15(7):1648. doi: 10.3390/nu15071648.

Abstract

The Nutrition Risk in Critically Ill score (NUTRIC) is an important nutritional risk assessment instrument for patients in the intensive care unit (ICU). The purpose of this study was to evaluate the power of the score to predict mortality in patients treated for sepsis and to forecast increased resource utilization and nursing workload in the ICU. The NUTRIC score predicted mortality (AUC 0.833, < 0.001) with the optimal cut-off value of 6 points. Among patients with a score ≥ 6 on ICU admission, the 28-day mortality was 61%, and 10% with a score < 6 ( < 0.001). In addition, a NUTRIC score of ≥6 was associated with a more intense use of ICU resources, as evidenced by a higher proportion of patients requiring vasopressor infusion (98 vs. 82%), mechanical ventilation (99 vs. 87%), renal replacement therapy (54 vs. 26%), steroids (68 vs. 31%), and blood products (60 vs. 43%); the nursing workload was also significantly higher in this group. In conclusion, the NUTRIC score obtained at admission to the ICU provided a good discriminative value for mortality and makes it possible to identify patients who will ultimately require intense use of ICU resources and an associated increase in the nursing workload during treatment.

摘要

营养风险评分(NUTRIC)是一种用于重症监护病房(ICU)患者的重要营养风险评估工具。本研究旨在评估该评分预测脓毒症患者死亡率的能力,并预测 ICU 中资源利用和护理工作量的增加。NUTRIC 评分预测死亡率(AUC 0.833,<0.001),最佳截断值为 6 分。在 ICU 入院时评分≥6 的患者中,28 天死亡率为 61%,而评分<6 的患者为 10%(<0.001)。此外,NUTRIC 评分≥6 与 ICU 资源的更密集使用相关,表现为需要血管加压素输注的患者比例更高(98% vs. 82%)、机械通气(99% vs. 87%)、肾脏替代治疗(54% vs. 26%)、类固醇(68% vs. 31%)和血液制品(60% vs. 43%);该组的护理工作量也明显更高。总之,ICU 入院时获得的 NUTRIC 评分对死亡率具有良好的判别价值,可识别最终需要密集使用 ICU 资源以及治疗期间护理工作量增加的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d749/10097365/786a71360637/nutrients-15-01648-g001.jpg

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