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Are all low-NUTRIC-score patients the same? Analysis of a multi-center observational study to determine the relationship between nutrition intake and outcome.

ΤίτλοςAre all low-NUTRIC-score patients the same? Analysis of a multi-center observational study to determine the relationship between nutrition intake and outcome.
Publication TypeJournal Article
Year of Publication2019
AuthorsChourdakis, M., Grammatikopoulou M. G., Day A. G., Bouras E., & Heyland D. K.
JournalClin Nutr
Volume38
Issue6
Pagination2783-2789
Date Published2019 12
ISSN1532-1983
Λέξεις κλειδιάAdult, Aged, Critical Illness, Female, Humans, Male, Malnutrition, Middle Aged, Nutrition Assessment, Nutritional Status, Nutritional Support, Risk Factors
Abstract

BACKGROUND: The NUTrition Risk in the Critically Ill (NUTRIC) scoring system is a tool useful, discriminating critically-ill patients benefiting from optimal nutrition intake (>80% of prescription). Recent recommendations advocate for withholding artificial nutrition among low-NUTRIC patients, however, we hypothesized that some low-NUTRIC patients would show an association between nutrition intake and outcome.METHODS: Patients were selected from the 2013-2014 International Nutrition Surveys when ICU length of stay (LICU) ≥72 h, baseline mNUTRIC score ≤4 and had at least three evaluable nutrition days (N = 2781). Proportion of prescription received during evaluable days was associated to 60-day hospital mortality by a logistic regression modelling. A priori, we expected that the association between proportion of prescription received and mortality might differ according to: LICU, BMI and prior unintentional weight loss or reduced oral intake.RESULTS: A total of 2781 patients fulfilled the inclusion criteria and participated in the study. Ten percent of the sample had a BMI <20 kg/m and 20% experienced either unintentional weight loss during the last 3 months, or reduced food intake over the last week. Sixty-day hospital mortality was 15% and median LICU reached 11.3 [6.3-21.7] days. Mean total prescription received by any means of nutritional support during the first 12 evaluable days was 57.4 ± 28.1% for energy and 53.7 ± 29.2% for protein. In the pooled, subgroup and sensitivity analyses, no significant associations were identified.CONCLUSION: Low-NUTRIC (≤4) patients demonstrate a prolonged LICU, while experiencing significant mortality and a high prevalence of malnutrition risk factors. Although improvements in mortality were not achieved with increased nutritional intake, this should not be construed as a rationale for withholding artificial nutrition among this patient group.

DOI10.1016/j.clnu.2018.12.006
Alternate JournalClin Nutr
PubMed ID30579667

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