Ability of the modified NUTRIC score to predict all-cause mortality among ICU patients with acute pancreatitis: A retrospective analysis using the MIMIC-IV database.

Abstract

Background: Acute pancreatitis (AP) is a common acute abdominal condition that can lead to severe complications. Malnutrition significantly impacts the prognosis of patients with AP, so effective tools are needed to identify those at high nutritional risk. This study validated the ability of the modified NUTRIC score to predict all-cause mortality and identify nutritional risk in patients with acute pancreatitis in the ICU.

Methods: This retrospective study analyzed data from the MIMIC-IV (v2.2) database, which included patients admitted to the ICU with AP between 2008 and 2019. Patients were categorized into high (mNUTRIC score ≥ 5) and low (mNUTRIC score < 5) nutritional risk groups. The findings were analyzed using Cox regression, ROC curve, and Kaplan-Meier survival analyses.

Results: A total of 670 AP patients were included in the study. Patients at high nutritional risk had significantly worse clinical outcomes, including higher 28-day (30.0% vs. 5.4%) and 90-day (39.41% vs. 10.2%) mortality rates, compared to patients with low nutritional risk. The mNUTRIC score demonstrated stronger predictive ability for the 28-day (AUC: 0.797) and 90-day (AUC: 0.772) mortality compared to other nutritional risk tools used in the ICU, including the SOFA, APACHE II, and OASIS scores. A Cox regression analysis revealed that higher mNUTRIC scores were independently associated with increased mortality risk. Kaplan-Meier analyses confirmed that patients at high nutritional risk had significantly lower survival probabilities than those at low risk (P<0.001). Patients with high nutritional risk who received nutrition intervention had a higher survival probability compared to those who did not (P < 0.001).

Conclusion: The mNUTRIC score is an effective tool for predicting the mortality in patients with AP. The mNUTRIC score stratifies patients with AP into different risk groups and predicts their all-cause mortality, highlighting the importance of nutritional interventions in improving survival outcomes, especially for patients at high risk.