{"title":"Comparison of nutritional risk status assessment tools in predicting 30-day survival in critically ill COVID-19 pneumonia patients.","authors":"Umut Sabri Kasapoglu, Abdullah Gok, Leman Acun Delen, Ayse Belin Ozer","doi":"10.5144/0256-4947.2022.236","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Few clinical studies have addressed nutritional risk assessment in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU).</p><p><strong>Objectives: </strong>Assess the nutritional risk status of the critically ill COVID-19 pneumonia patients admitted to the ICU, and compare the nutritional risk screening tools.</p><p><strong>Design: </strong>Medical record review SETTING: Tertiary critical care unit PATIENTS AND METHODS: We included adult (age >18 years) PCR-confirmed critically ill COVID-19 pneumonia cases admitted to the ICU between August 2020 and September 2021. Scoring systems were used to assess COVID-19 severity and nutritional status (mNUTRIC: modified Nutrition Risk in Critically Ill, NRS2002: Nutritional Risk Screening 2002). The 30-day mortality prediction performance of nutritional scores and survival comparisons between clinical and demographic factors were assessed.</p><p><strong>Main outcome measures: </strong>Compare the nutrition risk tools SAMPLE SIZE: 281 patients with a mean (SD) age of 64.3 (13.3) years; 143 (50.8%) were 65 years and older.</p><p><strong>Results: </strong>The mean mNUTRIC score of the cases was 3.81 (1.66) and the mean NRS-2002 score was 3.21 (0.84.), and 101 (35.9%) were at high risk of malnutrition according to the mNUTRIC score and 229 (81.4%) according to the NRS 2002 score. In cases at high risk of malnutrition by the mNUTRIC score there was a greater need for invasive mechanical ventilation, vasopressors, and renal replacement therapy (<i>P</i><.001 for all comparisons). The mNUTRIC score was superior to the NRS-2002 score in estimating 30-day mortality. In patients who died within 30 days, the mNUTRIC score and NRS-2002 score on the day of hospitalization were significantly higher (<i>P</i><.001), and the proportion of patients with NRS-2002 score ≥3 and mNUTRIC score ≥5 was significantly higher in the non-surviving group (<i>P</i><.001). In addition, patients with a high risk of malnutrition had a shorter survival time. The mNUTRIC score was an independent and important prognostic factor for 30-day mortality, and patients with an mNUTRIC score ≥5 had a 6.26-fold risk for 30-day mortality in the multivariate Cox regression.</p><p><strong>Conclusion: </strong>One third of critical COVID-19 pneumonia cases hospitalized in the ICU due to acute respiratory failure have a high risk of malnutrition, and a high mNUTRIC score is associated with increased mortality.</p><p><strong>Limitations: </strong>Single center retrospective study.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"236-245"},"PeriodicalIF":16.4000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/71/0256-4947.2022.236.PMC9357296.pdf","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5144/0256-4947.2022.236","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/8/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
引用次数: 2
Abstract
Background: Few clinical studies have addressed nutritional risk assessment in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU).
Objectives: Assess the nutritional risk status of the critically ill COVID-19 pneumonia patients admitted to the ICU, and compare the nutritional risk screening tools.
Design: Medical record review SETTING: Tertiary critical care unit PATIENTS AND METHODS: We included adult (age >18 years) PCR-confirmed critically ill COVID-19 pneumonia cases admitted to the ICU between August 2020 and September 2021. Scoring systems were used to assess COVID-19 severity and nutritional status (mNUTRIC: modified Nutrition Risk in Critically Ill, NRS2002: Nutritional Risk Screening 2002). The 30-day mortality prediction performance of nutritional scores and survival comparisons between clinical and demographic factors were assessed.
Main outcome measures: Compare the nutrition risk tools SAMPLE SIZE: 281 patients with a mean (SD) age of 64.3 (13.3) years; 143 (50.8%) were 65 years and older.
Results: The mean mNUTRIC score of the cases was 3.81 (1.66) and the mean NRS-2002 score was 3.21 (0.84.), and 101 (35.9%) were at high risk of malnutrition according to the mNUTRIC score and 229 (81.4%) according to the NRS 2002 score. In cases at high risk of malnutrition by the mNUTRIC score there was a greater need for invasive mechanical ventilation, vasopressors, and renal replacement therapy (P<.001 for all comparisons). The mNUTRIC score was superior to the NRS-2002 score in estimating 30-day mortality. In patients who died within 30 days, the mNUTRIC score and NRS-2002 score on the day of hospitalization were significantly higher (P<.001), and the proportion of patients with NRS-2002 score ≥3 and mNUTRIC score ≥5 was significantly higher in the non-surviving group (P<.001). In addition, patients with a high risk of malnutrition had a shorter survival time. The mNUTRIC score was an independent and important prognostic factor for 30-day mortality, and patients with an mNUTRIC score ≥5 had a 6.26-fold risk for 30-day mortality in the multivariate Cox regression.
Conclusion: One third of critical COVID-19 pneumonia cases hospitalized in the ICU due to acute respiratory failure have a high risk of malnutrition, and a high mNUTRIC score is associated with increased mortality.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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