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[Study of two variants of nutritional risk score “NUTRIC” in ventilated critical patients]
Dino Moretti1, Daniel Horacio Bagilet, Martín Buncuga
1de Clínica Médica y Terapéutica. Facultad de Ciencias Médicas. Universidad Nacional de Rosario.. morettidino@hotmail.com.
Introduction:
The NUTRIC score was proposed to assess the risk of adverse events potentially modifiable through nutritional intervention in critically ill patients. This score uses interleukin-6 (IL-6), a biomarker not always available.
Objective:
To study two variants of the score in patients with assisted mechanical ventilation (AMV): NUTRIC-1 without IL-6 and NUTRIC-2 with CRP as biomarker.
Methods:
Observational prospective cohort with 368 patients with AMV >24 hours. The predictive capacity of both NUTRIC scores was studied by binary logistic regression. The significance level was set at 5%.
Results:
mean age, 52 years; males 68%. Mean APACHE II score: 20.73 points. Death at the ICU: 196 (53%). Mean time on AMV of the survivals: 8.55 days. Mean NUTRIC-1 and NUTRIC-2 in the deceased-survivors: 4.23 - 3.06 (p = 0.000) and 4.68 -3.39 (p = 0.000). The mortality increased in relation to the score (p = 0.000). The calculated AUC for NUTRIC-1 and NUTRIC-2 were 0.671 (CI 0.617-0.726) and 0.679 (CI 0.624- 0.733). The mean CRP was higher in deceased patients: 13.07 mg/dL - 8.97 mg/dL (p = 0.001), the correlation improved with more days on AMV (p = 0.034 and p = 0.010) and the AUC increased in a similar way to IL-6 in the original work (0.008 and 0.007, respectively).
Conclusion:
The two studied variants of the NUTRIC score behaved similarly to the original NUTRIC score. The addition of the CRP improves the score performance and may be an alternative to IL-6, if it is not available.
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