Validation of the modified NUTrition Risk Score (mNUTRIC) in mechanically ventilated,severe burn patients: A prospective multinational cohort study |
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| Affiliation: | 1. Department of Medicine, Schulic School of Medicine and Dentistry, Trauma Program, London Health Sciences Center, London, ON, Canada;2. Department of Surgery, Schulic School of Medicine and Dentistry, Western University, Trauma Program, London Health Sciences Center, London, Ontario, Canada;3. Department of Surgery and Medicine, Schulic School of Medicine and Dentistry, Western University, Trauma Program, London Health Sciences Center, London, Ontario, Canada;4. Trauma Program, London Health Sciences Center, London, Ontario, Canada;5. Department of Radiology, Schulic School of Medicine and Dentistry, Western University, London, Ontario, Canada;6. Department of Medicine and Department of Epidemiology and Biostatistics, London Health Sciences Centre Trauma Program, London, Ontario, Canada |
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| Abstract: | BackgroundWhether nutrition therapy benefits all burn victims equally is unknown. To identify patients who will benefit the most from optimal nutrition, the modified Nutrition Risk in Critically Ill (mNUTRIC) Score has been validated in the Intensive Care Unit. However, the utility of mNUTRIC in severe burn victims is unknown. We hypothesized that a higher mNUTRIC (≥5) will be associated with worse clinical outcomes, but that greater nutritional adequacy will be associated with better clinical outcomes in patients with higher mNUTRIC score.MethodsThis prospective study included data from mechanically ventilated, severe burn patients (n = 359) from 51 Burn Units worldwide included in a randomized trial. Our primary and secondary outcomes were hospital mortality and the time to discharge alive (TTDA) from hospital. We described the association between nutrition performance and clinical outcomes.ResultsCompared to low mNUTRIC (n = 313), the high mNUTRIC group (n = 46) had higher mortality (61% vs. 19%, p = 0.001), and longer TTDA (>90 [87–>90] vs. 64 [38–90] days, p = <0.0001). Only in the high mNUTRIC group, increased calorie intake (per 20% increase) was associated with lower mortality and a faster TTDA.ConclusionsThe mNUTRIC score identifies those with poor clinical outcomes and may identifies those mechanically ventilated, severe burn patients in whom optimal nutrition therapy may be more advantageous. |
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| Keywords: | mNUTRIC Burns RE-ENERGIZE Nutritional risk Nutrition support Intensive care |
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