Prognostic value of Modified Nutric Score in determinig the disease severity and mortality of critically ill patients

Abstract

Many studies recommend late feeding or low-dose nutrition. Other studies do not recommend this type of nutritional support. To date, M Nutric scoring recommends early and aggressive nutritional support for high-risk patients, but we must consider the potential harms of fast invasive nutrition in critically ill patients. Therefore, evaluation of this score is necessary due to its effect on treatment and nutritional support of patients. Therefore, in this study, we aimed to evaluate the diagnostic value of M Nutric score in determining patient mortality and diagnosing disease severity. Materials and Methods: All patients admitted to the ICU (ICU of Martyrs and General Imam Reza) who are under mechanical ventilation were included in this study for 2 years from the beginning of April 1998 to the end of March 1999. All patients admitted to the ICU routinely underwent nutritional evaluation. Intral or parenteral nutritional support was provided within 48 hours of ICU admission. All patients were weighed to calculate energy and protein requirements and were used in patients with an ideal BMI of <30. The amount of energy was 25K cal / Kg of the patient's weight and in case of having stressors, these items were added to the total energy. Protein content of 0.8-1.2 g / kg was recorded for all patients. All patients' demographic information, disease severity, inpatient diagnosis, comorbidities, medications, intravenous fluids, energy and protein requirements daily and received were recorded Results: No significant correlation was observed between M Nutric score and age of patients (P = 0.406 and r = 0.039). There was a direct and significant relationship between M Nutric Score and SOFA, APACHE, length of stay in ICU, duration of mechanical ventilation and number of days dependent on vasopressor. These also increase (P <0.05). A significant inverse relationship was observed between M Nutric Score factor and energy and protein percentage variables of total energy and protein requirement, so that with increasing energy and protein percentage, M Nutric Score decreases (0.0001, respectively). > P, r = -0.215 and 0.0001> P, r = -0.222). Evaluation of sensitivity and specificity of M. Nutric Score for estimating mortality of mechanically ventilated patients Estimates M. Nutric Score score above 4, with a sensitivity of 71.7% and 100% specificity of mortality of mechanically ventilated patients..