High nutritional risk using NUTRIC-Score is associated with worse outcomes in COVID-19 critically ill patients

Osuna-Padilla, Iván Armando; Rodríguez-Moguel, Nadia Carolina; Aguilar-Vargas, Adriana

doi:10.20960/nh.03440

Cited by 17 publications

(17 citation statements)

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“…In this study, univariate analysis revealed that the risk of death increased with the risk of malnutrition according to NRS2002 (HR = 1.18). Osuna-Padilla et al showed that nutritional risk in mechanically ventilated ICU patients was related to an increased risk of death (OR = 2.4, and was found in 66% of patients [36]. A similar result was reported by Zhang et al, where nutritional risk was found in more than 60% of hospitalised patients.…”

Section: Discussionsupporting

confidence: 60%

The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU

et al. 2021

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Background: Coronavirus disease 2019 (COVID-19) has become one of the leading causes of death worldwide. The impact of poor nutritional status on increased mortality and prolonged ICU (intensive care unit) stay in critically ill patients is well-documented. This study aims to assess how nutritional status and BMI (body mass index) affected in-hospital mortality in critically ill COVID-19 patients Methods: We conducted a retrospective study and analysed medical records of 286 COVID-19 patients admitted to the intensive care unit of the University Clinical Hospital in Wroclaw (Poland). Results: A total of 286 patients were analysed. In the sample group, 8% of patients who died had a BMI within the normal range, 46% were overweight, and 46% were obese. There was a statistically significantly higher death rate in men (73%) and those with BMIs between 25.0–29.9 (p = 0.011). Nonsurvivors had a statistically significantly higher HF (Heart Failure) rate (p = 0.037) and HT (hypertension) rate (p < 0.001). Furthermore, nonsurvivors were statistically significantly older (p < 0.001). The risk of death was higher in overweight patients (HR = 2.13; p = 0.038). Mortality was influenced by higher scores in parameters such as age (HR = 1.03; p = 0.001), NRS2002 (nutritional risk score, HR = 1.18; p = 0.019), PCT (procalcitonin, HR = 1.10; p < 0.001) and potassium level (HR = 1.40; p = 0.023). Conclusions: Being overweight in critically ill COVID-19 patients requiring invasive mechanical ventilation increases their risk of death significantly. Additional factors indicating a higher risk of death include the patient’s age, high PCT, potassium levels, and NRS ≥ 3 measured at the time of admission to the ICU.

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Section: Discussionsupporting

confidence: 60%

The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU

et al. 2021

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“…Zhang et al [ 15 ], in a retrospective study conducted in China, reported that a large proportion of critically ill COVID-19 patients had a high nutritional risk (61%) as revealed by their mNUTRIC-Score. High-nutritional-risk scores were similarly prevalent (66%) in an observational study conducted in the central region of Mexico [ 17 ]. In both studies, the mNUTRIC-Score was able to independently predict the risk of death at 28 days.…”

Section: Discussionmentioning

confidence: 99%

“…The adjusted score was called the modified NUTRIC (mNUTRIC)-Score. During the COVID-19 pandemic, an increased prevalence of high nutritional risk has been reported in other studies of critically ill patients using the mNUTRIC-Score [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 93%

Use of mNUTRIC-Score for Nutrition Risk Assessment and Prognosis Prediction in Critically Ill Patients with COVID-19: A Retrospective Observational Study

Yanowsky-Escatell

Ontiveros-Galindo

Arellano-Arteaga

et al. 2021

Critical Care Research and Practice

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Introduction. Nutritional risk is highly prevalent in patients with COVID-19. Relevant data on nutritional assessment in the critically ill population are scarce. This study was conducted to evaluate the modified Nutrition Risk in the Critically Ill (mNUTRIC)-Score as a mortality risk factor in mechanically ventilated patients with COVID-19. Methods. We conducted this retrospective observational study in critically ill patients with COVID-19. Patients’ characteristics and clinical information were obtained from electronic medical records. The nutritional risk for each patient was assessed at the time of mechanical ventilation using the mNUTRIC-Score. The major outcome was 28-day mortality. Results. Ninety-eight patients were analyzed (mean age, 57.22 ± 13.66 years, 68.4% male); 46.9% of critically ill COVID-19 patients were categorized as being at high nutrition risk (mNUTRIC-Score of ≥5). A multivariate logistic regression model indicated that high nutritional risk has higher 28-day hospital mortality (OR = 4.206, 95% CI: 1.147–15.425, p = 0.030 ). A multivariate Cox regression analysis showed that high-risk mNUTRIC-Score had a significantly increased full-length mortality risk during hospitalization (OR = 1.991, 95% CI: 1.219–3.252, p = 0.006 ). Conclusion. The mNUTRIC-Score is an independent mortality risk factor during hospitalization in critically ill COVID-19 patients.

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“…A maior parte dos estudos seguiram delineamento observacional. Destes, a maioria (n = 5) se refere a pesquisas de coorte retrospectiva e ambidirecional, com dados de adultos hospitalizados durante um período da pandemia de COVID-19 (Formenti et al, 2021;Osuna-Padilla et al, 2021;Larrazabal Jr. et al, 2021;Wu et al, 2021;Lin et al, 2021). Também foi verificada a realização de estudo de intervenção (n = 1) (Watteville et al, 2020) e estudos longitudinais observacionais (n = 2) (Bedock et al, 2021;Nicolau et al, 2021).…”

Section: Fonte: Autores (2021)unclassified

“…Autores A utilização do escore de pontuação NUTRIC (Nutrition Risk in the Critically Ill Score) foi verificada em três estudos (Osuna-Padilla et al, 2021;Wu et al, 2021;Lin et al, 2021). O NUTRIC é um escore de risco nutricional para pacientes críticos desenvolvido e validado, especificamente, para pacientes em Unidades de Terapia Intensiva (UTI).…”

Section: Títulounclassified

Parâmetros nutricionais de indivíduos com COVID-19 hospitalizados em UTI

Rêgo¹,

Moura

2021

RSD

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Por se tratar de uma doença que afeta principalmente o sistema respiratório, a COVID-19 pode evoluir para uma situação mais crítica, levando até mesmo à falência de múltiplos órgãos, chegando a ser fatal. Quadros nos quais complicações respiratórias agudas passam a requerer permanência prolongada em Unidades de Terapia Intensiva (UTIs) são as principais causas de morbidade e mortalidade em pacientes com COVID-19. A permanência em UTI, sobretudo em tempo prolongado, é, por si só, uma causa da alteração de parâmetros nutricionais. Diante disto, o presente trabalho tem como objetivo analisar o comportamento do estado e parâmetros nutricionais de pacientes com COVID-19 admitidos em UTI durante o curso da pandemia. Foi realizada uma revisão integrativa da literatura, na qual foi utilizado método sistematizado para síntese e análise dos trabalhos científicos disponíveis. Verificou-se que, nos casos de pacientes COVID-19 agravados, em tratamento em UTI, constatou-se significativa presença de comorbidades como diabetes, hipertensão e associação destas entre os indivíduos hospitalizados, bem como mudanças no perfil de ingestão calórica e proteica e no balanço nitrogenado. Também foi constatado que desnutrição e moderado a alto risco nutricional foram considerados fatores de risco para maiores períodos de internação hospitalar. A possibilidade de investigação de parâmetros mais minuciosos é travessada pelo próprio contexto pandêmico, no qual a urgência no manejo dos pacientes e a necessidade de isolamento e adoção de protocolos sanitários muitas vezes impossibilita a realização das pesquisas científicas com pacientes críticos em decorrência da COVID-19.

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High nutritional risk using NUTRIC-Score is associated with worse outcomes in COVID-19 critically ill patients

Abstract: High nutritional risk using NUTRIC-Score is associated with worse outcomes in COVID-19 critically ill patientsAsociación entre el riesgo nutricional evaluado a través de NUTRIC-Score y los desenlaces clínicos en pacientes en estado crítico con

Cited by 17 publications

References 10 publications

The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU

The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU

Use of mNUTRIC-Score for Nutrition Risk Assessment and Prognosis Prediction in Critically Ill Patients with COVID-19: A Retrospective Observational Study

Parâmetros nutricionais de indivíduos com COVID-19 hospitalizados em UTI

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