Background

Nutrition status screening, assessment and monitoring is essential in the critically ill to reduce morbidity and mortality. Identifying patients’ at risk of malnutrition is usually difficult due to the nature of illness. Traditional screening methods are thought to be often limited due to their subjective nature. Purpose of this study is to determine the correlation of 3 different nutrition screening tools to classify the time consumed in identifying the risk of malnutrition.

Method

A sample of 44 patients expected to stay >24 hrs in ICU were assessed using the institution’s routine nutrition screening method; Subjective Global Assessment (SGA) & the NUTrition Risk in Critically ill (NUTRIC) score (age, APACHE II, SOFA, number of comorbidties, and days from hospital to ICU admission). Biochemical parameters, nutrient delivery, average length of stay (ALOS) in the ICU were also noted. GOS (Glasgow Outcome Scale) & Karnofsky performance status scale were the outcome scales used. Descriptive statistics & bivariate correlation were the statistical methods utilized.

Results

At risk of malnutrition was observed in 31.8% (n=14) using SGA, 27.3% (n=12) routine nutrition screening & 27.3% (n=12) NUTRIC score. There was significant correlation between all three tools (?*=0.05). Standard ALOS of <4.5 days (ICU) was seen in 18.2 %. Nutrient delivery of >75% was achieved among 72.7%. Only 6.8% had significant GOS (score 5) & 2.3% met the karnofsky performance status outcome (score 100).Time taken to complete routine nutrition screening, SGA & NUTRIC score, on an average was (approximately) 5, 7 and 15 minutes respectively.

Conclusion

On application of these tools, NUTRIC score is a more elaborate tool which includes various variables available in the ICU and is thought to be a superior score, by following it one may identify malnutrition appropriately. However the time taken for this new scoring system is higher. No significant difference in correlation was found between the traditional methods of nutrition screening and the NUTRIC score. Hence we had no added advantage of NUTRIC over traditional tools.