Abstract
Modified NUTRIC (mNUTRIC) score is a useful assessment tool to determine the risk of malnutrition in patients on mechanical ventilation (MV). We identified associations between postoperative calorie adequacy, 30-day mortality, and surgical outcomes in patients with high mNUTRIC scores. Medical records of 272 patients in the intensive care unit who required MV support for >24 h after emergency gastro-intestinal (GI) surgery between January 2007 and December 2017 were reviewed. Calorie adequacy in percentage (Calorie intake in 5 days ÷ Calorie requirement for 5 days × 100) was assessed in patients with high (5–9) and low (0–4) mNUTRIC scores. In the high mNUTRIC score group, patients with inadequate calorie supplementation (calorie adequacy <70%) had higher 30-day mortality than those with adequate supplementation (31.5% vs. 11.1%; p = 0.010); this was not observed in patients with low mNUTRIC scores. This result was also confirmed through Kaplan–Meier survival curve (p = 0.022). Inadequate calorie supplementation in the high mNUTRIC score group was not associated with Intra-abdominal infection (p = 1.000), pulmonary complication (p = 0.695), wound complication (p = 0.407), postoperative leakage (p = 1.000), or infections (p = 0.847). Inadequate calorie supplementation after GI surgery was associated with higher 30-day mortality in patients with high mNUTRIC scores. Therefore, adequate calorie supplementation could contribute to improved survival of critically ill postoperative patients with high risk of malnutrition.
Highlights
Adequate nutritional provision is important for critically ill patients [1,2,3]
Inadequate calorie supplementation after GI surgery was associated with higher 30-day mortality in patients with high Modified NUTrition RIsk in the Critically ill (NUTRIC) (mNUTRIC) scores
The study results are focused on patients with high mNUTRIC scores
Summary
Adequate nutritional provision is important for critically ill patients [1,2,3]. Kondrup et al [4]showed that adequate nutrition support for these patients resulted in improved clinical outcomes.In particular, patients at ‘high risk’ for malnutrition showed significant improvements, while ‘low risk’patients experienced minimal effects of nutrition support. Adequate nutritional provision is important for critically ill patients [1,2,3]. Showed that adequate nutrition support for these patients resulted in improved clinical outcomes. Identifying patients who are at high risk of malnutrition is an important role of intensivists and nutrition practitioners. It has always been challenging for intensivists to evaluate nutritional risk of intensive care unit (ICU) patients. Ill patients are in severe catabolic stress and have pro-inflammatory status due to increased release of stress-related hormones and cytokines [5]. Many ICU patients are on mechanical ventilation (MV), with no ability to communicate information about their previous nutritional status to clinicians.
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