Nutritional indices at admission are associated with mortality rates of patients in the intensive care unit

Shao, Yingmei; Lai, Qiancheng; Duan, Qing; Ge, Ping; Ye, Liu

doi:10.1038/s41430-021-00994-3

Cited by 10 publications

(13 citation statements)

References 37 publications

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“…CONUT categorizes patients into four states depending on the score (range 0–12), from normal to severe nutritional imbalance. Like PNI, CONUT was validated in a wide range of clinical scenarios and was associated with many ICU-related outcomes, from incidence of delirium [ 31 ] to mortality in various conditions such as trauma, heart failure, or irrespective of ICU-admittance cause [ 32 , 33 , 34 ]. While to this point there have been no published articles on the relevance of nutritional evaluation using CONUT in COVID-19 patients hospitalized solely in the ICU, the available data suggests that patients with a higher CONUT score were prone to more severe outcomes, having a more extended hospital stay, required mechanical ventilation more frequently, and had higher in-hospital mortality [ 35 , 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Risk Assessment Scores Effectively Predict Mortality in Critically Ill Patients with Severe COVID-19

et al. 2022

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Background: Malnutrition predicts a worse outcome for critically ill patients. However, quick, easy-to-use nutritional risk assessment tools have not been adequately validated. Aims and Methods: The study aimed to evaluate the role of four biological nutritional risk assessment instruments (the Prognostic Nutritional Index—PNI, the Controlling Nutritional Status Score—CONUT, the Nutrition Risk in Critically Ill—NUTRIC, and the modified NUTRIC—mNUTRIC), along with CT-derived fat tissue and muscle mass measurements in predicting in-hospital mortality in a consecutive series of 90 patients hospitalized in the intensive care unit for COVID-19-associated ARDS. Results: In-hospital mortality was 46.7% (n = 42/90). Non-survivors had a significantly higher nutritional risk, as expressed by all four scores. All scores were independent predictors of mortality on the multivariate regression models. PNI had the best discriminative capabilities for mortality, with an area under the curve (AUC) of 0.77 for a cut-off value of 28.05. All scores had an AUC above 0.72. The volume of fat tissue and muscle mass were not associated with increased mortality risk. Conclusions: PNI, CONUT, NUTRIC, and mNUTRIC are valuable nutritional risk assessment tools that can accurately predict mortality in critically ill patients with COVID-19-associated ARDS.

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Section: Discussionmentioning

confidence: 99%

Nutritional Risk Assessment Scores Effectively Predict Mortality in Critically Ill Patients with Severe COVID-19

et al. 2022

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“…PNI has become a prominent scoring system in terms of being a cost-effective method by saving time using albumin and lymphocyte parameters, which do not include clinical evaluation and measurements, require extra time in ICU practice, and are frequently examined in daily practice routines. It has been reported that a low PNI score is associated with poor outcomes and mortality [15]. In our study, in which we evaluated surgical ICU patients, the PNI score, which is on the agenda to predict prognosis, was significantly lower in the non-survivor group compared to the survivors.…”

Section: Discussionmentioning

confidence: 55%

“…Trauma cases; It is the patient group in which condi- tions that may cause muscle loss are more common due to the fact that immobilization is seen more frequently due to various reasons such as surgery, extremity damage, and the developing hypercatabolic state. Numerous scoring systems have been studied to evaluate malnutrition in ICU cases [15]. NRS-2002 is the scoring system frequently preferred in clinical practice to define nutritional risk.…”

Section: Discussionmentioning

confidence: 99%

Prognostic nutritional index to predicting mortality in surgical intensive care patients

Dal

Bozkurt

2022

Disaster Emerg Med J

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“…The other finding of our study is that malnutrition was an independent risk factor in all-cause mortality in critical patients with AMI. There are studies that demonstrated the impact of nutritional status on the prognosis of patients with myocardial infarction or critically ill. Yue Shao et al showed that undernutrition assessed by the nutritional indices [the Prognostic Nutritional Index score (PNI), CONUT, and the Geriatric Nutritional Risk Index (GNRI)] is strongly correlated with increased mortality rates of the patients in ICU ( 15 ). Sung HeeYooRN et al showed undernutrition evaluated by GNRI at admission was an independent factor influencing in-hospital death in patients with AMI ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Impact of Malnutrition in Critical Patients With Acute Myocardial Infarction: Results From Chinese CIN Cohort and American MIMIC-III Database

Huang

Wang

et al. 2022

Front. Nutr.

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BackgroundMalnutrition is associated with poor prognosis in patients with acute myocardial infarction (AMI). However, the prognostic impact of malnutrition in critical patients with AMI has not been well addressed.MethodsWe analyzed two critical AMI cohorts from Cardiorenal ImprovemeNt (CIN) in China and Medical Information Mark for Intensive Care-III (MIMIC-III) in the United States. The primary outcome was all-cause mortality. Cox proportional hazards models were constructed to examine the risk of malnutrition for mortality in critical patients with AMI.ResultsThere were 2,075 critical patients with AMI (mean age, 62.5 ± 12.3 years, 20.00% were female) from the CIN cohort and 887 critical patients with AMI (mean age, 70.1 ± 12.9 years, 37.43% were female) from MIMIC-III included in this study. Based on the Controlling Nutritional Status (CONUT) score, of the Chinese patients with AMI, the prevalence was 47.5, 28.3, and 3.5% for mild, moderate, and severe malnutrition, respectively. The percentage of mild, moderate, and severe malnutrition was 41.60, 30.55, and 7.32% in the MIMIC-III cohort, respectively. Controlling for confounders, worse nutritional state was significantly associated with increased risk for all-cause mortality [an adjusted hazard ratio for mild, moderate, and severe malnutrition, respectively, 1.10 (95% confidence interval (CI): 0.76–1.59), 1.49 (95% CI: 1.02–2.19), and 1.70 (95% CI: 1.00–2.88) in the CIN cohort and 1.41 (95% CI: 0.95–2.09), 1.97 (95% CI: 1.32–2.95), and 2.70 (95% CI: 1.67–4.37) in the MIMIC-III cohort].ConclusionMalnutrition was independently associated with an increased risk of all-cause mortality in critical patients with AMI after full adjustments. Further trials are needed to prospectively evaluate the efficacy of nutritional interventions in critical patients with AMI.

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Nutritional indices at admission are associated with mortality rates of patients in the intensive care unit

Cited by 10 publications

References 37 publications

Nutritional Risk Assessment Scores Effectively Predict Mortality in Critically Ill Patients with Severe COVID-19

Nutritional Risk Assessment Scores Effectively Predict Mortality in Critically Ill Patients with Severe COVID-19

Prognostic nutritional index to predicting mortality in surgical intensive care patients

Prevalence and Prognostic Impact of Malnutrition in Critical Patients With Acute Myocardial Infarction: Results From Chinese CIN Cohort and American MIMIC-III Database

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