Prognostic utility of adequate nutritional support in critically ill surgical patients as revealed by the modified nutrition risk in critically ill score.

BACKGROUND

The modified Nutrition Risk in the Critically Ill (mNUTRIC) score was developed to identify patients most likely to benefit from nutritional therapies and to stratify or select subjects for clinical trials. However, the validity of the score and the association between that score and the prognosis of patients in surgical intensive care units (SICUs) remain unclear. This study explored whether the score was a useful prognostic indicator for SICU patients, and whether survival could be improved via nutritional interventions based on mNUTRIC status.

METHODS

This retrospective observational study enrolled 123 patients admitted to our SICU for critical care from January 2018 to December 2019. Among these, mNUTRIC medical data were available for 116. In-hospital mortality rates were compared based on both mNUTRIC status and the adequacy of nutritional supplementation.

RESULTS

mNUTRIC-high status (5 points or more) was apparent in 16 ​% of all critically ill surgical patients. In-hospital mortality was significantly higher in those with mNUTRIC-high scores (42.1 ​% vs. 15.5 ​%, P ​= ​0.023). Both groups exhibited less mortality when nutrition was adequate vs. inadequate (5.0 ​% vs. 40.9 ​% and 26.7 ​% vs. 100 ​%, respectively). In multivariate analysis, mNUTRIC-high scores and inadequate nutritional support were significant risk factors for in-hospital mortality (hazard ratios 7.336 and 13.636, P ​= ​0.027 and 0.002, respectively).

CONCLUSION

In critically ill surgical patients, those identified as nutritionally high-risk using the mNUTRIC classification had poor in-hospital survival. Moreover, patients who received adequate nutritional support had a better prognosis than those who did not.