Nutritional indices at admission predict mortality in ICU patients

Nutritional indices at admission are predictive of higher mortality rates in adult patients in the intensive care unit (ICU), reveals a recent study.

A group of researchers retrieved information on 2,060 patients from the Medical Information Mart for Intensive Care III and randomized them into training and validation cohorts at a ratio of 7:3. They also estimated the patients’ nutritional indices using prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) score.

The prognostic role of nutritional indices in ICU mortality was assessed using both multivariate regression analysis and the Kaplan‒Meier survival curve. Finally, the researchers evaluated the additional predictive significance of each nutritional index beyond the baseline model including conventional risk factors.

On multivariate regression analysis, PNI, GNRI, and CONUT independently predicted in-hospital and 1-year mortality (p<0.001 for all). Kaplan‒Meier curves revealed higher 1-year mortality rates in having nutritionally at risk patients (PNI ≤38 or GNRI ≤98 or CONUT ≥2).

On subgroup analysis, each nutritional index significantly correlated with 1-year mortality in patients with different comorbidities. The addition of PNI, GNRI, and CONUT to the baseline model separately also showed an additional impact on the predictive value of 1-year mortality; this finding was further established in the validation cohort.

“Malnutrition is a common occurrence in critically ill patients and has been related to poor prognosis in various diseases,” the investigators said.