Assessment of nutritional status in critical ill patients by means of two Nutritional risk indexes
Keywords:
Nutritional status, critical care, mechanical ventilation, sepsis, mortality, nutritional risk.Abstract
Introduction: Nutritional status markers that better stratify risk in critically ill patients have yet to be established.
Objective: To assess nutritional risk in critically ill patients through the use of two assessment scales.
Material and Methods: A prospective descriptive cross-sectional study was conducted in 222 patients admitted to the Intensive Care Unit (8B) at the “Hermanos Ameijeiras” Hospital from September, 2017 to May, 2018. The Controlling Nutritional Status (CONUT) and the modified Nutrition Risk in the Critically ill (mNutric) were used.
Results: According to CONUT, 96.4% of patients were malnourished; according to mNutric, 27.5% of patients were categorized as high nutritional risk. There was an association between the scales (Kappa = 0.102). Among survivors, 78.3% of patients were at low risk according to mNutric score (p=0,013). There was an association between sepsis and malnutrition due to mNutric (p = 0.013) versus artificial mechanical ventilation (AMV) and malnutrition estimated by this scale (p = 0.116). No differences were found between sepsis and malnutrition according to CONUT (p = 0.126). There were differences between the AMV in relation to malnutrition according to CONUT score (p = 0.027). The frequency of deaths increased in parallel to the degree of malnutrition according to CONUT (p = 0.004). AMV was the variable that most influenced mortality (OR = 8,5).
Conclusions: According to CONUT, most of the patients were malnourished; according to mNutric, patients at low nutritional risk predominated. The predictive value of death in patients receiving AMV was demonstrated. The light and moderate malnutrition and the variable related with the not malnourished group (CONUT scale) were considered as categories associated with lower risk of death with regard to severe malnutrition.
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