Can nutritional status of patients in intensive care unit predict mortality and length of hospital stay? A single center retrospective case control study

To compare the hospitalization duration and mortality with the first day nutritional status of the patients who were hospitalized in intensive care unit of internal medicine department. The files of patients admitted to the ICU between 01-January-2017 and 30-June-2017 were retrospectively reviewed. Those who were not eligible for study in the selected files were later handed off. The remaining patients (169 patients) were evaluated for age, sex, stay in intensive care unit, APACHE2 and Glasgow scores, outcomes (exitus or discharge), NRS-2002 values in day of hospitalization, glucose, creatinine, albumin, White Blood Cell, hematocrit, thrombocyte, C-reactive protein and thyroid stimulating hormone (TSH) values were recorded. In addition, patients need for mechanical ventilation and underlying diseases (Chronic renal failure, cancer, sepsis, etc.) were recorded. The mean NRS-2002 score of the whole group was 4.28±0.90. The mean NRS-2002 score of discharged patients was 3.98±0.80 while the mean NRS-2002 score was 4.71±0.86 (p

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Campbell NN, Tooley MA, Willatts SM. APACHE II scoring system on a general intensive care unit: audit of daily APACHE II scores and 6-month survival of 691 patients admitted to a general intensive care unit between May 1990 and December 1991. J R Soc Med.1994;87:73-7.

Knox DB, Lanspa MJ, Pratt CM, et al. Glasgow Coma Score dominates the association between admission Sequential Organ Failure Assessment score and 30-day mortality in a mixed ICU population. J Crit Care. 2014;29:780-5.

Detsky AS, McLaughlin JR, Baker JP et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11:8-13.

Vellas B, Guigoz Y, Garry PJ, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15:116-22.

MAG—Guidelines for detection and management of malnutrition. Malnutrition Advisory Group (MAG) Redditch, UK: British Association for Parenteral and Enteral Nutrition; 2000.

Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional Risk Screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr.2003;22:321-36.

LeivaBadosa E, BadiaTahull M, Virgili Casas N, et al. Hospital malnutrition screening at admission: malnutrition increases mortality and length of stay. Nutr Hosp. 2017;34:907-13.

Stratton RJ, Hackston A, Longmore D, et al. Malnutrition in hospital outpatients and inpatients: Prevalence, concurrent validity and ease of use of the “malnutrition universal screening tool” (“MUST”) for adults. Br. J. Nutr. 2004;92:799-808.

Keusch, G.T. The history of nutrition: Malnutrition, infection and immunity. J. Nutr. 2003;133:336-40.

Bhaskaram, P. Micronutrient malnutrition, infection, and immunity: An overview. Nutr. Rev. 2002;60:40-5.

Dizdar OS, Baspınar O, Kocer D,et al. Nutritional risk, micronutrient status and clinical Outcomes: A prospective observational study in an infectious disease clinic. Nutrients. 2016;8:124.

Kimiaei-Asadi H, Tavakolitalab A. The assessment of the malnutrition in traumatic ICU patients in Iran. Electron Physician. 2017;9:4689-93.

Kosałka K, Wachowska E, Słotwiński R. Disorders of nutritional status in sepsis - facts and myths. Prz Gastroenterol. 2017;12:73-82.

Mercadal-Orfila G, Lluch-Taltavull J, Campillo-Artero C, et al. Association between nutritional risk based on the NRS-2002 test and hospital morbidity and ortality. Nutr. Hosp. 2012;27:1248-54.

Kuvandik G, Ucar E, Borazan A. et al. Markers of inflammation as determinants of mortality in intensive care unit patients Adv Ther. 2007;24:1078-84.

Cetinkaya A, Erden A, Avci D, et al. Is hypertriglyceridemia a prognostic factor in sepsis? Ther Clin Risk Manag. 2014;10:147-50.

Fuhrmann V, Kneidinger N, Herkner H. et al. Impact of hypoxic hepatitis on mortality in the intensive care unit. Intensive Care Med. 2011;37:1302-10.

Masopust J, Kratochvíl J, Martínková V, et al. The relation between nutritional risk category identified by the modified Nutritional Screening 2002 and mortality in metabolic intensive care unit. Vnitr Lek. 2008;54:817-20.

Planas M, Álvarez-Hernández J, León-Sanz M, Celaya-Pérez S, et al. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer. 2016;24:429-35.

Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer. Br J Surg. 2010;97:92-7.

Borek P, Chmielewski M, Małgorzewicz S et al. Analysis of Outcomes of the NRS 2002 in Patients Hospitalized in Nephrology Wards. Nutrients. 2017;9:287.

R Tan, J Long, S Fang, et al. Nutritional Risk Screening in CKD patients. Asia Pac J Clin Nutr. 2016;25:249-56

Caccialanza R, Klersy C, Cereda E, et al. Nutritional parameters associated with prolonged hospital stay among ambulatory adult patients. CMAJ. 2010;182:1843-9.