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The diagnosis and NUTRIC score of critically ill patients in enteral nutrition are risk factors for the survival time in an intensive care unit?

Isabela Bernasconi José , Vania Aparecida Leandro-Merhi , José Luis Braga de Aquino , José Alexandre Mendonça

Objective: to investigate whether the caloric and protein deficits, the diagnosis and the NUTRIC score, behaved as risk factors associated to the survival time. Methods: prospective study with 82 critically ill patients in intensive care unit (ICU), with exclusive enteral nutritional therapy (EENT). We investigated the calorie and protein deficiencies of EENT, the NUTRIC score, and the inflammatory-nutritional index by the C-reactive protein-CRP/albumin. The data were analyzed using the Chi-square, Fisher, Mann-Whitney, Kruskal-Wallis, univariate and multiple Cox regressions and the Kaplan-Meyer method. Results: in the univariate Cox regression, one-year increase in age increased the risk of death by 4.1% (p=0.0009; HR=1.041) and one-day increase with intercurrent events, by 1.8% (p = 0.0485; HR = 1.018). In the multiple Cox regression, the clinical diagnosis (p = 0.0462, HR = 2.091) and the NUTRIC score ≥ 5 (p < 0.0001; HR = 5.740) were the variables that together were associated with the survival time. The critical caloric and protein deficits did not behave as death risk factors in this population. Kaplan-Meier curves showed that the probability of survival in 40 days was 28.1% with clinical diagnosis and 40.2% with surgical diagnosis. The mean survival time with NUTRIC score ≥ 5 was 17.4 days. The probability of survival at 40 days was 72.8% with NUTRIC score < 5 and 6.4% with NUTRIC score ≥ 5. Conclusion: caloric and protein deficits are not risk factors for mortality. Only the diagnosis and the NUTRIC score were considered risk factors associated with the survival time.

Palabras Clave: Critically ill patient. Intensive care unit (ICU). Exclusive enteral nutritional therapy (EENT). NUTRIC score. Survival.

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