Comparison of Modified-NUTRIC, NRS-2002 and MUST Scores in Iranian Critically Ill Patients Admitted to Intensive Care Units: A Prospective Cohort Study.

BACKGROUND: There are no data on the validity of the modified Nutrition Risk in the critically ill (m-NUTRIC)-score and Nutritional Risk Screening (NRS)-2002 Score in the Iranian intensive care unit (ICU) patients. The Malnutrition Universal Screening Tool (MUST) is still used in most ICUs of Iran. Our goal was to test the validity of these tools in the Iranian ICU population.

METHODS: All adult patients (≥18 years) were included. The association between the nutritional risk scores and outcomes (longer-length of stay, prolonged-mechanical ventilation, and 28-day mortality) was assessed using the Multivariable Logistic regression. The performance of nutritional risk tools to predict 28-day mortality was assessed using the receiver operating characteristic (ROC)-curve. A Logistic regression model was used to test the interaction between nutritional risk category, energy adequacy, and 28-day mortality.

RESULTS: 440 patients were included. Both the m-NUTRIC and NRS-2002 scores were significantly associated with all three outcomes (all p < .001). However, the MUST had no significant association with longer-LOS (p = .151), prolonged-MV (p = .112), and 28-day mortality (p = .414).The area under the curve (AUC) for predicting 28-day mortality was 0.806(95% confidence interval [CI]: 0.756-0.851),0.695(95% CI: 0.632-0.752), and 0.551(95% CI: 0.483-0.612) for m-NUTRIC, NRS-2002, and MUST, respectively. Greater energy adequacy was associated with a lower 28-day mortality rate in high m-NUTRIC patients but not in low m-NUTRIC patients (p interaction = .015).

CONCLUSION: In the Iranian ICU population, the m-NUTRIC score may be a valid tool for identifying patients who would benefit from more aggressive nutrition therapy. This article is protected by copyright. All rights reserved.