NUTRIC Score modificado como indicador pronóstico de mortalidad en pacientes con shock séptico de la Unidad de Cuidados Intensivos del Hospital General del Norte de Guayaquil IESS Los Ceibos. 2018.

Abstract

Background: Sepsis is still considered a life-threatening condition and a challenge for intensive care units, since, although there are several scales that measure the risk of mortality, few studies have been developed to assess the relationship between nutritional risk and mortality after critical illness The Nutritional Risk score in Critical Illness (NUTRIC score), allows us to identify which patients can benefit from nutritional support, in order to modify the course of the disease and reduce the expected mortality in them. The present study was conducted to identify the mortality rate related to nutritional risk in ICU patients with septic shock based on the modified NUTRIC score (mNUTRIC) Methods: A retrospective, observational, descriptive study of patients admitted to the ICU with a diagnosis of septic shock (ICD-10 R572) was carried out at the General Hospital of the North of Guayaquil IESS Los Ceibos in 2018. The study included patients over 18 years of age who were admitted to the ICU and excluded if they were transferred to another ICU or hospital, electronic medical records were reviewed and data were collected on the variables required to calculate the mNUTRIC scores. The scores were based on data obtained during the first 24 hours after admission ICU Patients with mNUTRIC scores ≥5 were clear These are classified as "high", which means that they had a high mortality rate associated with an increased risk of malnutrition, while those with scores ≤4 were considered "low". Results: Sample: Mean age 70 years (SD 13.21, min 27, max 93), male (63.53%) and female (36.47%). The most frequent comorbidities were Diabetes Mellitus (37.65%) and neoplasms (15.3%). APACHE II scores between 9 - 20 (41.9%), SOFA score 10 - 16 (44.71%) and NUTRIC score ≥5 points (78.82%). Higher mortality was observed in patients with NUTRIC ≥5 (67.06%), in patients 66-93 years (63.07%), APACHE II ≥9 (75.29%), SOFA ≥6 (82.02%). In patients without nutritional support of any kind the mortality was 94.28%. Conclusion: The mortality rate was higher (67.06%) in the group of patients with NUTRIC scores ≥5. High mortality (94.28%) was observed in patients without nutritional support. 38.83% could benefit from receiving nutritional support therapy.