Systemic inflammatory markers as a supplement to nutrition risk screening of ICU patients.

Abstract

Background and objectives: Critical illness often leads to life-threatening organ dysfunction requiring intensive care. This catabolic condition significantly affects nutrition, causing muscle loss, weakness, and an in-creased risk of malnutrition, which complicates recovery. Traditional nutritional assessment tools often face limitations in critically ill patients. Systemic inflammation may improve the accuracy of nutritional risk screening.

Methods and study design: Data from the MIMIC-IV database were analyzed. The study aimed to assess the prognostic value of inflammatory markers combined with the mNUTRIC score. Survival analyses were conducted using Kaplan-Meier curves and Cox regression models to evaluate the association between these markers and patient mortality at 30-day, 60-day, and 90-day intervals.

Results: A total of 2,628 ICU patients were included. High C-reactive protein (CRP; cut-off value 75.2 mg/L) had a hazard ratio (HR) of 1.345 (Log-rank p = 0.004), high neutrophil-to-lymphocyte ratio (NLR; cut-off value 8.16) had an HR of 1.266 (Log-rank p = 0.021), and albumin (cut-off value 35 g/L) was associated with an HR of 0.576 (Log-rank p < 0.001). For 60-day and 90-day mortality, similar trends were observed, with significant p-values.

Conclusions: Combining inflammatory markers such as CRP, NLR, and albumin with the mNUTRIC score enhances mortality prediction in critically ill patients, improving clinical decision-making. Further research with larger, multicenter cohorts is needed.