The clinical study of Nutric score system and nutritional assessment in neurological critical ill patients

Abstract

Objective To investigate the clinical utility of critical nutrients nutrition risk assessment(Nutric score) in neurological critical ill patients, laying the foundation for clinical nutrition support. Methods From July 2016 to March 2017, 59 ICU patients with neurological critical ill in the First Affiliated Hospital of Anhui Medical University were divided into low score group(Nutric score 0-4) and high score group(Nutric score 5-9) according to Nutric score system.On the first and seventh day after ICU admission, the body mass index(BMI), triceps skinfold thickness (TSF), mid-upper arm circumference (MAC) and mid-upper arm muscle circumference (MAMC) were measured.The serum albumin(ALB), prealbumin(PA), hemoglobin(Hb) and lymphocyte(LY) were detected as nutritional indicators.And at the same time, recorded the 28-day outcomes, and made the SGA evaluation. Results At the first day admission in ICU, there were no statistically significant differences between the two groups in TSF, MAC and MAMC (all P>0.05). But at the seventh day, the TSF, MAC, MAMC of the high score group were (0.943±0.484)cm, (24.143±3.203)cm, (21.187±2.625)cm, respectively, which were significantly lower than those of the low score group[(1.185±0.403)cm, (26.981±2.731)cm, (23.265±2.327)cm], there were statistically significant differences between the two groups(t=2.090, 3.672, 3.223, all P<0.05). At the first day after admission, the serum levels of ALB and Hb in the high score group were (34.5±7.3)g/L, (103.68±13.5)g/L, which of the low score group were (39.0±6.9)g/L, (122.29±20.4)g/L, respectively, and there were statistically significant differences between the two groups(t=2.466, 4.168, all P<0.05). And at the seventh day after admission, the serum levels of ALB, PA, Hb and Ly in the high score group were (30.6±5.1)g/L, (146.0±77.0)mg/L, (83.9±11.9)g/L, (1.123±0.535)×109/L, respectively, which were significantly lower than those in the low score group[(35.8±5.5)g/L, (209.9±105.1)mg/L, (105.8±19.2)g/L, (1.709±1.377)×109/L]. Compared with the first day after admission, the ALB, Hb levels in the two groups at the seventh day after admission were significantly decreased (t=2.29, 2.042, 5.817, 3.286, all P<0.05); the PA level in the low score group had no statistically significant difference at the seventh day after admission, but the PA level in the high score group was decreased significantly (t=2.024, P<0.05). The incidence rate of malnutrition, mortality of the high score group were 32.1%, 32.1%, respectively, which were significantly higher than those in the low score group (9.7%, 6.5%) (χ2=4.583, 6.402, all P<0.05). Conclusion The Nutric score system can be used in the purpose of early nutrition assessment in neurological critical ill patients, and it is benefit for clinical early nutritional support. Key words: Nutric score system; Neurological; Critical illness