Impact of Body Mass Index on the Survival of Patients with Sepsis with Different Modified NUTRIC Scores

Abstract

Nutritional status affects the survival of patients with sepsis. This retrospective study analyzed the impact of body mass index (BMI) and modified nutrition risk in critically ill (mNUTRIC) scores on survival of these patients. Data of 1291 patients with sepsis admitted to the intensive care unit (ICU) were extracted. The outcomes were mortality, duration of stay, ICU stay, and survival curve for 90-day mortality. Logistic regression analysis was performed to examine the risk factors for mortality. Cytokine and biomarker levels were analyzed in 165 patients. The 90-day survival of underweight patients with low mNUTRIC scores was significantly better than that of normal-weight patients with low mNUTRIC scores (70.8% vs. 58.3%, respectively; p = 0.048). Regression model analysis revealed that underweight patients with low mNUTRIC scores had a lower risk of mortality (odds ratio = 0.557; p = 0.082). Moreover, normal-weight patients with low mNUTRIC scores had the lowest human leukocyte antigen DR (HLA-DR) level on days 1 (underweight vs. normal weight vs. overweight: 94.3 vs. 82.1 vs. 94.3, respectively; p = 0.007) and 3 (91.8 vs. 91.0 vs. 93.2, respectively; p = 0.047). Thus, being underweight may not always be harmful if patients have optimal clinical nutritional status. Additionally, HLA-DR levels were the lowest in patients with low survival.

Application of Peak Glucose Range and Diabetes Status in Mortality Risk Stratification in Critically Ill Patients with Sepsis

“…This might be because the patients with diabetes had more comorbidities compared to patients without diabetes. In our previous study, we noted that the increase of HbA1c had a tendency to decrease the mortality in patients with sepsis and a poor nutrition status, and cancer was related with a significant independent increase in mortality risk [35]. In this study, patients with DM had higher HbA1C levels and fewer cancers than patients without DM.…”

Modified Nutrition Risk in Critically ill is an effective nutrition risk screening tool in severely burned patients, compared with Nutrition Risk Screening 2002

“…It is recommended by ESPEN (European Society for Parenteral and Enteral Nutrition) for screening nutrition risk in hospitalized patients. The threshold for the mNUTRIC remains controversial, with different studies using different cut-off values depending on the performance of the data ( 21 , 22 ). In this present study, considering that the population in this study included severely burned patients admitted to the ICU after injury, and that the conversion score for the “days from admission to ICU” entry in mNUTRIC was 0, a new cut-off value was identified according to the Youden’s index.…”

The Survival of Septic Patients with Compensated Liver Cirrhosis Is Not Inferior to That of Septic Patients without Liver Cirrhosis: A Propensity Score Matching Analysis

“…The study was part of an integrated research program. It consisted of a prospective observation study, including an immune profile study and retrospective medical chart review [ 13 , 14 , 15 , 16 , 17 ]. It was conducted in three medical ICUs at Kaohsiung Chang Gung Memorial Hospital (34 beds), a 2700-bed tertiary teaching hospital in southern Taiwan.…”