DR DIVYA VASIREDDY,DR RAHUL RAJ C.L,DR KHALILUR RAHMAN,DR DAKSHAY CHORDIA,DR. RAMYA CHELLAMMAL .M
DOI: https://doi.org/Background:
Malnutrition is a significant concern in critically ill patients, particularly those with multiple organ failure. The NUTRIC score is a nutritional risk assessment tool specifically developed for critically ill patients to predict mortality and increased resource utilization, such as the need for mechanical ventilation and longer hospital stays. This study aims to assess the predictive utility of the modified NUTRIC (mNUTRIC) score in intensive care unit (ICU) patients diagnosed with sepsis.
Methods:
A prospective observational study was conducted in the ICU of a tertiary care hospital, involving 40 patients diagnosed with sepsis. The mNUTRIC score, which excludes interleukin-6 (IL-6) due to its limited availability in clinical settings, was calculated within 24 hours of ICU admission. Patients were categorized into low-risk (mNUTRIC score <4) and high-risk (mNUTRIC score ≥5) groups. The study evaluated the association between mNUTRIC scores and clinical outcomes, including ICU length of stay (LOS), hospital LOS, need for mechanical ventilation, renal replacement therapy, and mortality at 28 days and at hospital discharge.
Results:
The study found that patients in the high-risk group (n=11) were significantly older (median age 76 vs. 60 years, p < 0.001) and had a lower body mass index (BMI) (median 23 vs. 24 kg/m², p = 0.003) compared to the low-risk group (n=29). High-risk patients also had significantly higher APACHE II, SAPS II, and SOFA scores (p < 0.001 for all). Mechanical ventilation was required more frequently in the high-risk group (72.7% vs. 62.1%, p < 0.001), and sepsis was more prevalent (63.6% vs. 17.2%, p < 0.001). The high-risk group had longer ICU stays (median 6 vs. 4 days, p < 0.001), higher 28-day mortality (36.4% vs. 10.3%, p < 0.001), and higher in-hospital mortality (45.5% vs. 6.9%, p < 0.001). Additionally, acute kidney injury (AKI) was more common in the high-risk group (72.7% vs. 41.4%, p < 0.001).
Conclusion:
The mNUTRIC score effectively predicts mortality and increased resource utilization in ICU patients with sepsis. High mNUTRIC scores are associated with greater severity of illness, higher mortality, and greater need for intensive care resources. These findings suggest that the mNUTRIC score can be a valuable tool in identifying high-risk ICU patients who may benefit from early and aggressive nutritional and medical interventions.
