Assessment of nutritional risk and associated determinants in adult intensive care unit patients: a prospective longitudinal observational study comparing NRS-2002 and mNUTRIC.

Abstract

Background: Malnutrition is common in critically ill patients and increases morbidity and mortality. Nutritional assessment is a fundamental component of nursing care; therefore, early identification of nutritional risk is essential for timely interventions in intensive care units (ICUs).

Aim: This study evaluated nutritional risk in adult ICU patients, identified associated clinical and biochemical factors and compared the applicability of Nutritional Risk Screening 2002 (NRS-2002) and modified Nutrition Risk in the Critically Ill (mNUTRIC) scoring systems.

Methods: This prospective longitudinal observational study was conducted in an adult ICU. Nutritional risk was assessed within 24-48 hours of admission and on day seven using NRS-2002 and mNUTRIC. Clinical, nutritional and biochemical variables were analysed using inferential and multivariate statistical methods.

Results: A total of 300 patients were included. According to NRS-2002, 87.7% and 83.7% of patients were at nutritional risk at the first and second assessments, respectively, whereas 57.0% and 59.7% were classified as low risk by mNUTRIC. NRS-2002 scores remained stable over time (p > 0.05), whereas mNUTRIC scores decreased significantly (p < 0.05). Age, caloric intake, C-reactive protein, albumin, haematocrit and blood glucose were significant predictors of nutritional risk, and both tools correlated positively with age.

Conclusion: Nutritional risk is common among ICU patients. Both NRS-2002 and mNUTRIC identified patients at nutritional risk; however, mNUTRIC assessment reflected changes in disease severity and clinical status during ICU follow-up. These findings highlight the importance of routine nurse-led nutritional risk assessment to support early nutritional interventions and optimise patient care in the ICU.