The Role of CRP and mNUTRIC score in predicting outcome in critically ill elderly.

Abstract

Background: Malnutrition is highly prevalent in hospitalized patient and higher in critically ill patients admitted to an intensive care unit (ICU), it is associated with increased length of hospital stay, decreased quality of life, and increased mortality.Early recognition of patients who are at high nutritional risk may improve their clinical outcomes as these patients may benefit more from nutritional interventions than those at lower nutritional risk. So, proper assessment of risk of malnutrition should be done for ICU patients. The aim of this study is to determine the role of CRP on admission and mNUTRIC score in predicting ICU patient outcome. Methods: A prospective cohort study involved 155 elderly patients aged 60 years and above recruited from geriatric intensive care unit in Ain Shams University Hospital. Data collection included history taking (personal history, past medical history), cause of ICU admission, comorbidities, APACHI II score, SOFA score, mNUTRIC score was calculated from the previous data taken on admission. A venous blood sample was collected from each participant to measure CRP on admission. Results:The in hospital mortality of the studied population was 61/155 (39.35%). The non survivors had higher mean CRP, mNUTRIC, SOFA, and APACHE II scores. The mNUTRIC >4 has a 70.49% sensitivity and 87.33% specificity in predicting mortality with AUC= 0.844. While CRP level > 80 has a sensitivity 70.49% and specificity 71.28% in predicting mortality with AUC= 0.738.Conclusion: CRP and m-NUTRIC score obtained at admission to the ICU had moderate accuracy for predicting ICU mortality.