Association Of Modified NUTRIC Score And NRS-2002 With Outcome In Critically Ill Patients

Objective: We aim to investigate the association of modified NUTrition RIsk in Critically ill(mNUTRIC)score and Nutrition Risk Screening 2002(NRS-2002)with clinical outcomes in critically ill patiens.Methods:A multicenter prospective cohort study was conducted to collect the population data of critically ill patients who were 18 years old or older than 18 years old,and the duration of ICU staying in for 5 days or more than 5 days and the duration of the nutrition treatment for more than 48 hours.We collected the patients’ data which met the criteria above from 2017.3.to 2017.8 in one hospital.We use multiple factors of logistic regression analysis,and use the data of the ICU APACHE II scores,SOFA scores,NRS-2002,modified NUTRIC scores,staying into the ICU before hospitalization days,days ICU stay and mechanical ventilation days,28 days and 90 days clinical outcome(live or die),and other clinical data to evaluate the prognostic value of modified nutrition risk(NUTRIC)score and NRS-2002 in critically ill patients.Results: Among the 100 patients who were selected,94 patients had NRS-2002 greater than 3,suggesting that 94% of patients with ICU had nutritional risks.28 days of clinical outcome: 62 of the 100 patients survived,38 of whom died,and 38 percent died.Comparison between survival group and death way: APACHE II scores between the two groups,modified NUTRIC SOFA scores,number of days of mechanical ventilation there are differences between groups,with statistical significance(P<0.05).Age,NRS-2002,albumin,prealbumin,retinol binding protein,into the ICU before hospitalization days,ICU stay days there was no significant difference between groups,with no statistical significance(P > 0.05).With the patient’s prognosis(death or survival)as the dependent variable,a binary logistic regression analysis was used to show that the improved NUTRIC score was an independent risk factor for the clinical prognosis of patients with critical illness in 28 days(P<0.05).The clinical outcome was 90 days: in 100 patients,56 died,44 died,and the fatality rate was 44%.Comparison between survival group and death way: Age distribution and APACHEII scores,SOFA score,NRS-2002,improved NUTRIC score,number of days of mechanical ventilation were significant differences between groups,with statistical significance(P<0.05).There was no significant differences between the survival group and the death group,ALB,PA,retinol binding protein,ICU stay days,and the number of days before ICU.No statistical significance(P>0.05).To patient prognosis(dead or alive)as the dependent variable,the binary classification logistic regression analysis,shows improved NUTRIC score during mechanical ventilation,ICU days is 90 days critically ill patients independent risk factors of clinical prognosis.The improved NUTRIC score was significantly higher than the low group(P<0.05),and the mortality rate and number of days of mechanical ventilation were significantly higher than that in the low group(P<0.05).Conclusion: The mNUTRIC score is significantly associated with 28-day mortality,90-day mortality and mechanical ventilation in critically ill patients and can be used to predict the prognosis of critically ill patients.The NRS-2002 has no such performence.