ACMJ

Anatolian Current Medical Journal (ACMJ) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Prediction of mortality in patients admitted to the intensive care unit due to respiratory failure; use of nutritional screening tools mNUTRIC and NRS-2002
Aims: The objective of this study was to examine the effectiveness of the nutritional screening tools modified nutrition risk in the critically ill (mNUTRIC) and nutrition risk screening-2002 (NRS-2002) in predicting mortality among patients admitted to the intensive care unit (ICU) with acute respiratory failure (ARF) and to determine if their effectiveness varies by respiratory failure (RF) type.
Methods: This prospective, cohort, descriptive study was initiated after ethics committee approval. During a 6-month period, all adult patients (aged ?18 years) admitted to the tertiary ICUs with acute RF, with type 1 and type 2 RF, who stayed for more than 48 hours were included. Patients were divided into two groups: survivors and non-survivors. Nutritional screening was performed with mNUTRIC and NRS-2002. Scores of 5 points or more on any of the nutritional tools were considered to indicate high nutritional risk. Multiple logistic regression analysis was used to test data predicting 1-month (30-day) and 3-month (90-day) mortality. Relative risk (RR) values of the nutritional tools on mortality were calculated.
Results: Among 525 patients, 35.4% had type 1 RF, and 64.6% had type 2 RF. The mortality rates were 44.2% at one month and 62.5% at three months, with higher mortality observed in type 1 RF in both periods. The mNUTRIC score, the presence of inotropic support, type 1 RF, and admission from the ward were identified as independent variables with a significant association with mortality at 1 and 3 months. The mNUTRIC score emerged as the variable most strongly associated with mortality in both periods. When the mNUTRIC score was evaluated in isolation, the optimal cut-off value was determined to be 6 (1-month mortality AUC: 0.77, 3-month mortality AUC: 0.82). Patients with nutritional risk, as identified by mNUTRIC, exhibited a fourfold elevated risk of mortality within one month (RR=4.2; 95% CI: 2.56–6.95; p<.001) and three months (RR=4.6; 95% CI: 3.04–7.15; p<.001). Combining mNUTRIC and NRS-2002 scores did not significantly enhance predictive accuracy compared to mNUTRIC alone.
Conclusion: In patients with RF, the mNUTRIC score is the most powerful parameter for identifying the high-risk group. The prognosis is worse in patients with type 1 RF compared to type 2. Especially in the group of patients with high mNUTRIC score, in need of inotropic support, type 1 RF findings, and the need for ICU during hospitalization, early intervention and management in terms of nutrition is important to improve the duration of intensive care stay and mortality rates.


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Volume 7, Issue 2, 2025
Page : 111-119
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