The positive relationship between NUTRIC score, bioelectric measures and hospital mortality in critically ill patients

Abstract

Purpose Bioelectrical impedance vector analysis (BIVA) and phase angle (PA) have importance in assessing nutritional and prognosis, and this study hypothesized that these measurements can have a relationship with nutritional risk and outcomes. This study aims to analyze the association between Nutrition Risk in the Critically ill (NUTRIC) score and bioelectrical impedance measures with hospital mortality in critically ill patients. Design/methodology/approach A prospective, cohort study was performed with a consecutive sample of patients admitted to an intensive care unit (ICU), between January and June 2017 at a hospital university in Northwest Brazil. The NUTRIC score and the bioelectric measures, such as resistance (R), reactance (Xc), PA and BIVA, were completed within the first 24 h of admission. The Student’s t or Mann–Whitney, Pearson’s or Spearman’s coefficient and Fisher’s exact tests and BIVA were used for statistical analyses. Findings The sample consisted of 81, with a mean age of 57 (16.7) years, with 60.5% women. It was detected that PA and Xc were lower (p < 0.001), and age was higher (p < 0.001) in a high nutritional-risk group. It was found an association between low nutritional risk and hospital discharge (p < 0.001), and that individuals who died spent more days in the ICU (p = 0.0375), had significantly lower PA and Xc values (p = 0.043 and p = 0.0172, respectively) and higher NUTRIC scores (<0.0001). There was a displacement of the mean impedance vector in men and women with high nutritional risk (p = 0.0037 and p = 0.004, respectively). Research limitations/implications The height measurement was estimated using predictive formulas, which may affect the accuracy of the values; BIA was performed only upon admission of the patient to the ICU and the study population was heterogeneous, as it is a general ICU. Originality/value This paper shows that, in critically ill patients, nutritional screening and the assessment of bioelectrical measures help in clinical-nutritional decisions, and were able to predict outcomes.