Modified nutrition risk in critically ill (mNUTRIC) score on admission and mortality in acute heart failure patients admitted to the cardiac intensive care unit.

Abstract

The modified nutrition risk in critically ill (mNUTRIC) score was developed to quantify the risk of adverse events related to malnutrition in the intensive care unit setting. However, its prognostic value has not been examined in patients with acute heart failure (AHF). This study aimed to investigate the relationship between mNUTRIC score and all-cause mortality in AHF patients in the cardiac intensive care unit (CCU). We retrospectively examined 307 patients with AHF who were admitted to our CCU from April 2014 to March 2017. mNUTRIC score was calculated within 24 h of CCU admission. Patients were classified as either high nutritional risk (score ≥ 5) or low nutritional risk (score < 5). The primary endpoint was death from any cause. Median follow-up was 272 days (interquartile range 59-588). Kaplan-Meier survival analysis showed that overall survival was significantly worse in the high nutritional risk group (p < 0.001). In the multivariate analysis adjusted for chronic kidney disease, systolic blood pressure, hypoalbuminemia, anemia, and C-reactive protein concentration, mNUTRIC score ≥ 5 was an independent predictor of higher all-cause mortality (adjusted hazard ratio, 2.23; 95% confidence interval, 1.33-3.72; p = 0.003). mNUTRIC score ≥ 5 at admission to the CCU is associated with increased risk of mortality in AHF patients in the CCU.