Is Nutrition risk in critically ill (NUTRIC) Score necessary to analyze the nutritional risk?


Identifying patients who are at nutritional risk is a core competency of Clinical Dietitians. Hence, this study was conducted to identify the reliable and convenient tool for the evaluation of nutritional risk in critically ill and their impact on the clinical outcomes.

A prospective observational study was conducted in multidisciplinary critical care unit (CCU) of tertiary care hospital from Feb till April 2016. All patients who were admitted into CCU, initiated on enteral nutrition were included. Patients’ demographics, severity of illness (ie, Acute Physiology and Chronic Health Evaluation (APACHE) score II), Sequential Organ Failure Assessment (SOFA)), NUTRIC Score, baseline markers of nutritional status (ie, subjective global assessment (SGA), and body mass index (BMI)) and outcomes were recorded. Statistical analyses using Pearson’s correlation, Chi-Square test were applied with SPSS version 20.

During the study period, 158 patients were admitted into CCU with mean age of 60.15±16.3, comprising of 69% males and 31% females. The mean APACHE and SOFA score were 19.15±5.26, 7.45±3.56 respectively. On admission, SGA revealed that 63% were malnourished and as per NUTRIC evaluation, 47% required aggressive nutrition support. Out of 158 patients, 7 patients were still in hospital before analysis and the average length of stay (LOS) in CCU and hospital for the remaining were 10.27±10.80 and 14.03±12.18 respectively. Among 74 patients (47%) required aggressive nutrition support as per NUTRIC score, only 47 patients were found to be malnourished as evidenced by SGA. There is a difference found between the NUTRIC score and SGA in the identification of nutritional risk. Significant correlation was observed between NUTRIC, SOFA and APACHE-II Score (p<0.05).

SGA is a simple bed side tool to identify the patients at risk of malnutrition and since the NUTRIC score is time consuming and laborious, it can be used only in patients who are assessed to be undernourished on admission into CCU for aggressive nutritional management.