Background: Malnutrition in intensive care unit (ICU) patients is associated with adverse clinical outcomes. The nutrition risk in the critically ill score (NUTRIC) was proposed as an appropriate nutritional assessment tool in critically ill patients. This score uses interleukin-6 (IL-6), a biomarker that is not always available. This prospective observational study was conducted to identify the nutritional risk in ICU patients using the modified NUTRIC (mNUTRIC) score (which does not include IL-6) and to explore the relationship between 28-day mortality and high mNUTRIC scores.
Methods: The data were extracted from The Beijing Acute Kidney Injury Trial (BAKIT). This trial was a prospective, observational, multi-centre study conducted in 30 ICUs at 28 tertiary hospitals in Beijing, China, from March 1 to August 31, 2012. In total, 9049 patients were admitted consecutively, and 3107 patients with complete clinical data were included in this study. The predictive capacity of the mNUTRIC score was studied by receiver operating characteristic (ROC) curve analysis. The significance level was set at 5%.
Results: Among the 3107 patients, the 28-day mortality rate was 17.4% (540 patients died). High nutritional risk patients were older (P<0.001), with higher illness severity scores than low nutritional risk patients. Multivariate analysis revealed that the mNUTRIC score was an independent risk factor for 28-day mortality and mortality increased with increasing scores (p = 0.000). The calculated area under curve (AUC) for the mNUTRIC score was 0.763 (CI 0.740 - 0.786).
Conclusions: Nearly 28.2% of patients admitted to the ICU were at risk of malnutrition, and a high mNUTRIC score was associated with increased ICU length of stay and higher mortality.
Trial Registration: This study was registered at www.chictr.org.cn (registration number Chi CTR-ONC-11001875). Registered on 14 December 2011.Key words:The modified nutrition risk in critically ill score, Intensive care unit, Mortality