NUTRIC_score_guideline v.1

Nutrition Risk in the Critically Ill (NUTRIC) Score identifies patients who are particularly likely to have a mortality benefit from aggressive nutrition therapy.

Maryam Razavi

maryam.razavi@cambio.se

CambioCDS

To assist clinicians to identify critically ill patients who can benefit from nutrition therapy, recommended by the American College of Gastroenterology (ACG) guidelines for nutrition therapy.

NUTRIC score can be used to assist clinicians to identify critically ill patients who can benefit from nutrition therapy, recommended by ACG guidelines. NUTRIC Score Formula: Additional of the selected points: - Age: <50=0, 50-74=1, ≥75=2 - APACHE II: <15=0, 15–19=1, 20–27=2, ≥28=3 - SOFA Score (Initial, on presentation): <6=0, 6–9=1, ≥10=2 - Number of comorbidities: 0-1=0, ≥2=1 - Days in the hospital to ICU admit: 0=0, ≥1=1 - IL-6 (µ/mL): 0–399, ≥400=1 Note: NUTRIC score can be calculated without IL-6, which is not commonly ordered in many ICU settings, without sacrificing significant predictive power. Interpretations: NUTRIC Score 0= Low Risk = ~1% 28-day mortality NUTRIC Score 1= Low Risk = ~2% 28-day mortality NUTRIC Score 2= Low Risk = ~3% 28-day mortality NUTRIC Score 3= Low Risk = ~8% 28-day mortality NUTRIC Score 4= Low Risk = ~11% 28-day mortality NUTRIC Score 5= Low Risk = ~20% 28-day mortality NUTRIC Score 6= High Risk = ~30% 28-day mortality NUTRIC Score 7= High Risk = ~45%28-day mortality NUTRIC Score 8= High Risk =~58% 28-day mortality NUTRIC Score 9= High Risk =~70% 28-day mortality NUTRIC Score 10= High Risk = ~80%28-day mortality

1. Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care. 2011;15(6):R268. 2. Kalaiselvan MS, Renuka MK, Arunkumar AS. Use of Nutrition Risk in Critically ill (NUTRIC) Score to Assess Nutritional Risk in Mechanically Ventilated Patients: A Prospective Observational Study. Indian J Crit Care Med. 2017;21(5):253-256. 3. Rahman A, Hasan RM, Agarwala R, Martin C, Day AG, Heyland DK. Identifying critically-ill patients who will benefit most from nutritional therapy: Further validation of the "modified NUTRIC" nutritional risk assessment tool. Clin Nutr. 2016;35(1):158-62. 4. Rosa M, Heyland DK, Fernandes D, Rabito EI, Oliveira ML, Marcadenti A. Translation and adaptation of the NUTRIC Score to identify critically ill patients who benefit the most from nutrition therapy. Clin Nutr ESPEN. 2016;14:31-36. 5. Compher C, Chittams J, Sammarco T, Nicolo M, Heyland DK. Greater Protein and Energy Intake May Be Associated With Improved Mortality in Higher Risk Critically Ill Patients: A Multicenter, Multinational Observational Study. Crit Care Med. 2017;45(2):156-163. 6. Mcclave SA, Dibaise JK, Mullin GE, Martindale RG. ACG Clinical Guideline: Nutrition Therapy in the Adult Hospitalized Patient. Am J Gastroenterol. 2016;111(3):315-34.

OBSERVATION.basic_demographic.v1, OBSERVATION.nutric_score.v0