Identifying critically ill patients with cirrhosis who benefit from nutrition therapy: the mNUTRIC score study.

Autor:	Tripathi H; Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India., Benjamin J; Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India., Maiwall R; Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India., Puri P; Section of Gastroenterology, Hepatology and Nutrition, Hunter Holmes McGuire VA, Medical Center, Virginia Commonwealth University, Richmond VA, United States., Kapoor PB; Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India., Shasthry V; Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India., Saluja V; Department of Anesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India., Agrawal P; Department of Anesthesia and Critical Care, Institute of Liver and Biliary Sciences, New Delhi, India., Kumar G; Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India., Joshi YK; Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India., Sarin SK; Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
Jazyk:	angličtina
Zdroj:	Journal of clinical and translational research [J Clin Transl Res] 2022 Sep 13; Vol. 8 (5), pp. 425-433. Date of Electronic Publication: 2022 Sep 13 (Print Publication: 2022).
Abstrakt:	Background and Aim: Malnutrition increases risk of mortality in critically ill patients with cirrhosis. Modified Nutrition Risk in Critically ill (mNUTRIC) score is a validated tool to identify at risk patients who may benefit from goal-directed nutrition therapy. We aimed to study the association between mNUTRIC score and 28-day mortality in critically ill patients with cirrhosis. Methods: A prospective study was conducted in the liver intensive care unit of a quaternary teaching institute. Baseline and follow-up data pertaining to mNUTRIC score, clinical, hemodynamic, biochemical, nutritional parameters, mechanical ventilation, length of ICU stay, and development of sepsis were collected. Correlation between mNUTRIC score and its modulation by nutritional adequacy was determined. Results: One hundred and fifty patients were enrolled. Out of these, 116 (77%) had a high NUTRIC score (HNS) and 34 (23%) had a low NUTRIC score (LNS). Patients with HNS had higher mortality (54% vs. 10%; P = 0.008), longer mechanical ventilation ( P = 0.02), and high incidence of sepsis (32% vs. 2.6%; P = 0.002) compared to LNS. The probability of survival increased with increase in nutritional adequacy ( P < 0.01) in patients with HNS. Conclusion: mNUTRIC score is a useful tool for identifying nutrition risk in critically ill patients with cirrhosis. Goal-directed nutrition therapy in patients with HNS can significantly improve survival. Relevance for Patients: Critically ill patients with cirrhosis who are at a higher nutritional risk as identified by the mNUTRIC score may have a better survival benefit if higher calorie and protein adequacy are achieved in the ICU. Competing Interests: The authors declare no conflicts of interest. (Copyright: © 2022 Author(s).)
Databáze:	MEDLINE
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