NRS-2002-defined nutritional risk and associated factors in intensive care unit patients: a cross-sectional study

Malnutrition is common in intensive care units (ICUs) and is associated with adverse clinical outcomes. This study aimed to evaluate NRS-2002-defined nutritional risk in adult ICU patients and to examine factors associated with high nutritional risk.

This cross-sectional study was conducted in a tertiary-level ICU of a training and research hospital in Türkiye between April 2024 and May 2025. A total of 169 adult patients were included. Nutritional risk was assessed using the Nutritional Risk Screening-2002 (NRS-2002), and patients were classified as low (< 3) or high (≥ 3) risk. Disease severity was evaluated using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Group comparisons were performed using the Mann-Whitney U and chi-square tests. Factors associated with high nutritional risk were examined using modified Poisson regression with robust variance, and adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) were reported.

The median age of the patients was 74 years, and patients at high nutritional risk were significantly older than those at low nutritional risk (p = 0.018). Enteral or parenteral nutrition was more common in the high-risk group (p < 0.001). In the adjusted analysis, absence of sedative medication use (aPR: 0.800, 95% CI: 0.646-0.990) and higher hemoglobin level (aPR: 0.898, 95% CI: 0.852-0.948) were associated with a lower prevalence of high nutritional risk.

Sedative medication use and lower hemoglobin levels were identified as clinical correlates of NRS-2002-defined high nutritional risk in ICU patients. These findings support the importance of regular nutritional risk screening in ICU settings and suggest that nutritional risk may not always be fully reflected by disease severity scores alone. Further multicenter studies with larger samples are needed to better clarify factors associated with nutritional risk in ICU populations.