Prediction of mortality in patients admitted to the intensive care unit due to respiratory failure; use of nutritional screening tools mNUTRIC and NRS-2002

Onur Küçük; Fatih Seğmen; Semih Aydemir

Makale detayları

Prediction of mortality in patients admitted to the intensive care unit due to respiratory failure; use of nutritional screening tools mNUTRIC and NRS-2002

Yazarlar:

Onur Küçük | Fatih Seğmen | Semih Aydemir

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Yoğun Bakım

Dergi:

Anatolian Current Medical Journal Vol.7 Issue 2, pp.111-119

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343178

pISSN:

2718-0115

Anahtar kelimeler:

Özet:

 Aims: The objective of this study was to examine the effectiveness of the nutritional screening tools modified nutrition risk in the critically ill mNUTRIC and nutrition risk screening-2002 NRS-2002 in predicting mortality among patients admitted to the intensive care unit ICU with acute respiratory failure ARF and to determine if their effectiveness varies by respiratory failure RF type. Methods: This prospective, cohort, descriptive study was initiated after ethics committee approval. During a 6-month period, all adult patients aged 18 years admitted to the tertiary ICUs with acute RF, with type 1 and type 2 RF, who stayed for more than 48 hours were included. Patients were divided into two groups: survivors and non-survivors. Nutritional screening was performed with mNUTRIC and NRS-2002. Scores of 5 points or more on any of the nutritional tools were considered to indicate high nutritional risk. Multiple logistic regression analysis was used to test data predicting 1-month 30-day and 3-month 90-day mortality. Relative risk RR values of the nutritional tools on mortality were calculated. Results: Among 525 patients, 35.4 had type 1 RF, and 64.6 had type 2 RF. The mortality rates were 44.2 at one month and 62.5 at three months, with higher mortality observed in type 1 RF in both periods. The mNUTRIC score, the presence of inotropic support, type 1 RF, and admission from the ward were identified as independent variables with a significant association with mortality at 1 and 3 months. The mNUTRIC score emerged as the variable most strongly associated with mortality in both periods. When the mNUTRIC score was evaluated in isolation, the optimal cut-off value was determined to be 6 1-month mortality AUC: 0.77, 3-month mortality AUC: 0.82. Patients with nutritional risk, as identified by mNUTRIC, exhibited a fourfold elevated risk of mortality within one month RR4.2; 95 CI: 2.566.95; p.001 and three months RR4.6; 95 CI: 3.047.15; p.001. Combining mNUTRIC and NRS-2002 scores did not significantly enhance predictive accuracy compared to mNUTRIC alone. Conclusion: In patients with RF, the mNUTRIC score is the most powerful parameter for identifying the high-risk group. The prognosis is worse in patients with type 1 RF compared to type 2. Especially in the group of patients with high mNUTRIC score, in need of inotropic support, type 1 RF findings, and the need for ICU during hospitalization, early intervention and management in terms of nutrition is important to improve the duration of intensive care stay and mortality rates.

 Aims: The objective of this study was to examine the effectiveness of the nutritional screening tools modified nutrition risk in the critically ill mNUTRIC and nutrition risk screening-2002 NRS-2002 in predicting mortality among patients admitted to the intensive care unit ICU with acute respiratory failure ARF and to determine if their effectiveness varies by respiratory failure RF type. Methods: This prospective, cohort, descriptive study was initiated after ethics committee approval. During a 6-month period, all adult patients aged 18 years admitted to the tertiary ICUs with acute RF, with type 1 and type 2 RF, who stayed for more than 48 hours were included. Patients were divided into two groups: survivors and non-survivors. Nutritional screening was performed with mNUTRIC and NRS-2002. Scores of 5 points or more on any of the nutritional tools were considered to indicate high nutritional risk. Multiple logistic regression analysis was used to test data predicting 1-month 30-day and 3-month 90-day mortality. Relative risk RR values of the nutritional tools on mortality were calculated. Results: Among 525 patients, 35.4 had type 1 RF, and 64.6 had type 2 RF. The mortality rates were 44.2 at one month and 62.5 at three months, with higher mortality observed in type 1 RF in both periods. The mNUTRIC score, the presence of inotropic support, type 1 RF, and admission from the ward were identified as independent variables with a significant association with mortality at 1 and 3 months. The mNUTRIC score emerged as the variable most strongly associated with mortality in both periods. When the mNUTRIC score was evaluated in isolation, the optimal cut-off value was determined to be 6 1-month mortality AUC: 0.77, 3-month mortality AUC: 0.82. Patients with nutritional risk, as identified by mNUTRIC, exhibited a fourfold elevated risk of mortality within one month RR4.2; 95 CI: 2.566.95; p.001 and three months RR4.6; 95 CI: 3.047.15; p.001. Combining mNUTRIC and NRS-2002 scores did not significantly enhance predictive accuracy compared to mNUTRIC alone. Conclusion: In patients with RF, the mNUTRIC score is the most powerful parameter for identifying the high-risk group. The prognosis is worse in patients with type 1 RF compared to type 2. Especially in the group of patients with high mNUTRIC score, in need of inotropic support, type 1 RF findings, and the need for ICU during hospitalization, early intervention and management in terms of nutrition is important to improve the duration of intensive care stay and mortality rates.

 Aims: The objective of this study was to examine the effectiveness of the nutritional screening tools modified nutrition risk in the critically ill mNUTRIC and nutrition risk screening-2002 NRS-2002 in predicting mortality among patients admitted to the intensive care unit ICU with acute respiratory failure ARF and to determine if their effectiveness varies by respiratory failure RF type. Methods: This prospective, cohort, descriptive study was initiated after ethics committee approval. During a 6-month period, all adult patients aged 18 years admitted to the tertiary ICUs with acute RF, with type 1 and type 2 RF, who stayed for more than 48 hours were included. Patients were divided into two groups: survivors and non-survivors. Nutritional screening was performed with mNUTRIC and NRS-2002. Scores of 5 points or more on any of the nutritional tools were considered to indicate high nutritional risk. Multiple logistic regression analysis was used to test data predicting 1-month 30-day and 3-month 90-day mortality. Relative risk RR values of the nutritional tools on mortality were calculated. Results: Among 525 patients, 35.4 had type 1 RF, and 64.6 had type 2 RF. The mortality rates were 44.2 at one month and 62.5 at three months, with higher mortality observed in type 1 RF in both periods. The mNUTRIC score, the presence of inotropic support, type 1 RF, and admission from the ward were identified as independent variables with a significant association with mortality at 1 and 3 months. The mNUTRIC score emerged as the variable most strongly associated with mortality in both periods. When the mNUTRIC score was evaluated in isolation, the optimal cut-off value was determined to be 6 1-month mortality AUC: 0.77, 3-month mortality AUC: 0.82. Patients with nutritional risk, as identified by mNUTRIC, exhibited a fourfold elevated risk of mortality within one month RR4.2; 95 CI: 2.566.95; p.001 and three months RR4.6; 95 CI: 3.047.15; p.001. Combining mNUTRIC and NRS-2002 scores did not significantly enhance predictive accuracy compared to mNUTRIC alone. Conclusion: In patients with RF, the mNUTRIC score is the most powerful parameter for identifying the high-risk group. The prognosis is worse in patients with type 1 RF compared to type 2. Especially in the group of patients with high mNUTRIC score, in need of inotropic support, type 1 RF findings, and the need for ICU during hospitalization, early intervention and management in terms of nutrition is important to improve the duration of intensive care stay and mortality rates.

 Amaç: Bu çalışmanın amacı, Kritik Hastalarda Modifiye Beslenme Riski mNUTRIC ve Beslenme Riski Taraması-2002 NRS-2002 beslenme tarama araçlarının solunum yetmezliği SY ile yoğun bakım ünitesine YBÜ kabul edilen hastalarda mortaliteyi tahmin etmedeki etkinliğini ve bu etkinliğin SY tipine göre değişip değişmediğini incelemektir. Yöntemler: Bu prospektif, kohort, tanımlayıcı çalışma etik kurul onayından sonra başlatıldı. Altı aylık bir süre boyunca, üçüncü basamak YBÜlere akut SY ile kabul edilen, tip 1 ve tip 2 SY olan ve 48 saatten fazla kalan tüm yetişkin hastalar 18 yaş dahil edildi. Hastalar hayatta kalanlar ve hayatta kalmayanlar olmak üzere iki gruba ayrıldı. Beslenme taraması mNUTRIC ve NRS-2002 ile yapıldı. Beslenme araçlarından herhangi birinden alınan 5 puan veya üzeri skorlar yüksek beslenme riski göstergesi olarak kabul edildi. Çoklu lojistik regresyon analizi, 1 aylık 30 günlük ve 3 aylık 90 günlük mortaliteyi öngören verileri test etmek için kullanıldı. Beslenme araçlarının mortalite üzerindeki rölatif risk RR değerleri hesaplandı. Sonuçlar: Çalışma popülasyonu akut SY ile başvuran 525 hastadan oluşmaktaydı ve bunların 35,4ünde tip 1 SY ve 64,6sında tip 2 SY vardı. Mortalite oranları bir ayda 44,2 ve üç ayda 62,5 olup her iki dönemde de tip 1 SYde daha yüksek mortalite gözlendi. mNUTRIC skoru, inotropik destek varlığı, tip 1 SY ve servisten kabul, 1. ve 3. aylarda mortalite ile anlamlı ilişkisi olan bağımsız değişkenler olarak tanımlandı. mNUTRIC skoru her iki dönemde de mortalite ile en güçlü şekilde ilişkili değişken olarak saptandı. mNUTRIC skoru tek başına değerlendirildiğinde, optimum kesme değeri 6 olarak belirlendi. mNUTRIC tarafından tanımlanan beslenme riski olan hastalarda, bir ay ve üç ay içinde dört kat daha yüksek mortalite riski saptandı. Sonuç: SYli hastalarda, mNUTRIC skoru yüksek riskli grubu tanımlamak için en güçlü parametredir. Tip 1 SYli hastalarda prognoz tip 2ye kıyasla daha kötüdür. Özellikle mNUTRIC skoru yüksek, inotropik desteğe ihtiyaç duyan, tip 1 SY bulguları olan ve servis yatışı sırasında YBÜ ihtiyacı doğan hasta grubunda beslenme açısından erken müdahale ve yönetim, yoğun bakımda kalış süresini ve mortalite oranlarını iyileştirmek için önemlidir.

Makale detayları

Prediction of mortality in patients admitted to the intensive care unit due to respiratory failure; use of nutritional screening tools mNUTRIC and NRS-2002

Yazarlar:

Onur Küçük | Fatih Seğmen | Semih Aydemir

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Yoğun Bakım

Dergi:

Anatolian Current Medical Journal Vol.7 Issue 2, pp.111-119

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343178

pISSN:

2718-0115

Acute respiratory failure

intensive care unit

mortality

mNUTRIC

NRS-2002akut solunum yetmezliği

yoğun bakım ünitesi

mortalite

mNUTRIC

NRS-2002

Sayı

Makale detayları

Yazarlar: Onur Küçük | Fatih Seğmen | Semih Aydemir

Yayıncı: MediHealth Academy Yayıncılık

Ana Başlıklar: Yoğun Bakım

Dergi: Anatolian Current Medical Journal Vol.7 Issue 2, pp.111-119

Belge Tipi: Makale

Yayın Tarihi: 3/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001343178

pISSN: 2718-0115

Sayı

Yazarlar:

Onur Küçük | Fatih Seğmen | Semih Aydemir

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Yoğun Bakım

Dergi:

Anatolian Current Medical Journal Vol.7 Issue 2, pp.111-119

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343178

pISSN:

2718-0115