Translation and adaptation of the NUTRIC Score to identify critically ill patients who benefit the most from nutrition therapy

Abstract

Due to the scarcity of tools to assess the nutritional risk in critically ill patients, the NUTrition Risk in the Critically ill Score (NUTRIC Score) was developed and validated primarily in a limited population to quantify the risk of adverse events that may be modified by aggressive nutrition therapy. The objective of this study was to translate and adapt the NUTRIC Score into Portuguese language for further demonstrate its feasibility and clinical utility in Brazilian Intensive Care Units (ICUs). This translation and adaptation process is part of a study for the validation of NUTRIC Score in Brazil. Translation was performed according to standardized steps: initial translation, synthesis of translations, back-translation, revision and application of the instrument by specialists and evaluation of cultural adaptation. We conducted a pilot study within 50 patients mechanically ventilated for more than 48h in four ICUs in Southern Brazil to determine the prevalence of patients who were the most likely to benefit from aggressive nutrition therapy. The translation and adaptation process produced a valid version of NUTRIC Score in the Portuguese language. The translated version was easily introduced into four Brazilian ICUs and the prevalence of patients with high score and likely to benefit from aggressive nutritional intervention (mean age 61.4±15.3 years) was 46% (23 individuals, 95%CI 0.33-0.60). The NUTRIC Score has been successfully translated into Portuguese and the prevalence of nutritionally-high risk patients may be around 50% in Brazilian ICUs.