Comparison between the NUTRIC score and modified NUTRIC score to predict hospital mortality in cardiac surgery patients: A retrospective study

Abstract

Background Nutritional status is essential for patients undergoing cardiac surgery (CS), and malnutrition is an independent risk factor for postoperative adverse outcomes. The Nutrition Risk in the Critically Ill (NUTRIC) and modified NUTRIC (mNUTRIC) scores are nutritional risk assessment tools specifically for patients in the intensive care unit (ICU). The objective of this study was to validate and compare the accuracy of the NUTRIC score and the mNUTRIC score in predicting hospital mortality in CS patients. Methods This retrospective study screened adult CS patients under cardiopulmonary bypass in the ICU of a tertiary university affiliated hospital in China from June 2020 to August 2022. The demographic data, laboratory variables, clinical outcomes and hospital mortality of these patients were recorded, and all data were compared according to the NUTRIC score and the mNUTRIC score criteria for high and low nutritional risk. The area under the receiver operating characteristic curve (AUC-ROC) was used to compare the predictive performance of these two nutrition scores for hospital mortality. Results A total of 259 eligible patients were finally screened for statistical analysis; 57 patients had high NUTRIC scores, and 82 patients had high mNUTRIC scores. In both scores, patients in the high nutritional risk group had a higher rate of renal replacement therapy, longer duration of mechanical ventilation and ICU stay, and higher hospital mortality than those in the low nutritional risk group (p < 0.001). The AUC-ROC of the NUTRIC score and the mNUTRIC score for predicting hospital mortality were 0.833 (95% CI: 0.754–0.911) and 0.827 (95% CI: 0.751–0.902), respectively. There was no significant difference in ROC curves between the two scores (p = 0.532). Conclusions Both the NUTRIC and mNUTRIC scores showed good predictive performance for hospital mortality in CS patients, and the NUTRIC score was not superior to the mNUTRIC score.