Influence of nutritional risk assessment on the prognosis of trauma patients

Background: malnutrition negatively impacts trauma prognosis, and this study aimed to evaluate the Nutrition Risk Index (NRI) as a prognostic factor alongside other variables such as comorbidities and the Barthel Index (BI). Objective: to evaluate the NRI as a prognostic factor while considering other variables, including nutritional parameters, comorbidities, and the Barthel Index. Although mortality was the primary outcome, we will clarify this to avoid any confusion. Methods: a cohort of 80 Chinese trauma patients, aged 30-69 years, was analyzed through prospective data collection at admission and post-discharge, covering mortality, nutritional factors, and prognostic indicators. The average observation period was 5.83 months, with an average admission age of 45.6 years. Results: this study examined the relationship between nutritional parameters, trauma, and their effects on mortality and survival. The 6-month survival rate was 93 %, and a correlation was noted between mortality risk and patients with Nutritional Risk Index (NRI) scores greater than 96. However, those with severe risk (NRI < 83.5) did not show a significant association with mortality, possibly due to a small sample size (n = 4), suggesting the need for larger studies to further explore this relationship. The Cox proportional hazard analysis identified older age, lower NRI scores, and specific comorbidities like ischemic heart disease, chronic kidney disease, and hypertension as significant mortality risk factors. Additionally, types of fractures, particularly radius and ulna and vertebral fractures, were linked to higher mortality. Lower Barthel Index scores at admission and discharge were significant predictors of mortality; however, deceased patients often had higher BI scores, indicating that a low BI cannot be universally regarded as a risk factor. Conclusion: overall, the findings emphasize that older age, lower NRI scores, and comorbidities are critical predictors of mortality in trauma patients, while the relationship between the Barthel Index and outcomes requires further clarification.