The relationship between acute physiology and chronic health evaluation-II, sequential organ failure assessment, Charlson comorbidity index and nutritional scores and length of intensive care unit stay of patients hospitalized in the intensive care unit due to chronic obstructive pulmonary disease

Abstract

Aim: It is known that disease severity and nutritional status are determinants of prognosis in patients hospitalized in the intensive care unit (ICU). Different scoring systems are used to evaluate the nutritional status and disease severity of intensive care patients. It will be very useful in clinical practice to determine the intensive care scores that are in harmony with the nutritional parameters and affect the length of stay in the ICU in patients hospitalized with the diagnosis of chronic obstructive pulmonary disease (COPD). It was aimed to determine the relationship between acute physiology and chronic health evaluation-II (Apache-II), sequential organ failure assessment (SOFA), and Charlson comorbidity index (CCI) with nutritional scores in intensive care patients with a diagnosis of COPD. Also, it was aimed to determine the scoring systems that affect the length of stay in the ICU.
 Material and Method: Nutritional risk score-2002 (NRS-2002), prognostic nutritional index (PNI), modified nutritional risk in critically ill (mNutric) score, albumin, Apache-II, SOFA and CCI values and intensive care unit length of stay of the patients hospitalized in the intensive care unit due to COPD were recorded. The scoring systems that affect the length of stay in the ICU and the relationship between nutritional scores and Apache-II, SOFA and CCI was analyzed using statistical methods.
 Results: A significant correlation was found between only CCI and all nutritional scores. Only the CCI value was found to be significantly higher in those found to be at high risk compared to all nutritional scoring systems. CCI cut-off value determined according to nutritional scoring was determined as 4.5 according to PNI and albumin, and 5.5 according to mNutric score and NRS-2002. It was determined that CCI affects the length of stay in the intensive care unit.
 Conclusion: CCI is a scoring system that is compatible with nutritional parameters and affects the length of stay in the intensive care unit. Therefore, we think that CCI can be used to predict prognosis and nutritional risk in patients with COPD in the intensive care unit and to predict the length of stay in the intensive care unit. In terms of malnutrition risk, a cut-off value of ≥6 can be used for CCI.