Translation of the modified NUTRIC score and adaptation to the Greek ICU setting

Abstract

Patients in the intensive care unit are experiencing an increased malnutrition risk. The NUTrition Risk in the Critically ill score (NUTRIC) is a validated tool for the identification of patients that will benefit the most, from nutritional intervention. The aim of the study was twofold, including: 1) to translate and adapt the NUTRIC score in the Greek language for more efficient and comprehensive use among clinicians, and 2) to assess its prognostic performance in a pilot sample. The translation process followed standardized steps: 1) initial translation, 2) synthesis of different translations, 3) back -translation to the English language, 4) revision and cultural adaptation of the instrument by an expert committee. A pilot application study was conducted on 80 critically ill patients from three ICUs in Greek hospitals. The NUTRIC score was calculated using the final translated version. The translated score was considered easy to use, fast and comprehensive. No specific corrections were suggested by the expert committee. According to the translated version of the score 56% of the screened patients were classified as of high nutritional risk (score between 5 and 9). Compared to the low - NUTRIC patients, high - NUTRIC patients were older (56.4±16.4 vs. 68.7±12.7yrs, p<0.001), had increased APACHE (13.8±6.5 vs. 23.8±6.5, p<0.001) and SOFA scores (4.7±3.1 vs. 10.4±3.1, p<0.001) and demonstrated more comorbidities. Elevated 28 -day mortality was observed among high -NUTRIC patients compared to the low - NUTRIC ones (6 vs. 18 patients, p<0.05). The Greek version of the NUTRIC score is ready for use among health care professionals employed in intensive care units in Greek speaking countries, aiming to discriminate critically ill patients benefiting from enhanced nutritional support.