Comparación del escore NUTRIC, NUTRICm y NUTRICpcr en pacientes críticos ventilados por COVID-19

Introduction: The COVID-19 pandemic caused a dramatic increase in ICU admissions due to severe acute respiratory syndrome. The NUTRIC score (with IL-6) and its variants NUTRICm (without IL-6) and NUTRICpcr (CRP instead of IL-6) were proposed to evaluate nutritional risk (RN) and even prognosis in critically ill patients. Methods: Scores with inflammatory biomarkers (NUTRIC and NUTRICpcr) and without them (NUTRICm) were evaluated through a prospective and observational study to discriminate mortality and assess NB in patients ventilated for COVID-19. Results: 418 patients were analyzed. The median (IQR) age and APACHE II were: 54 years (6-61) and 13 points (10-19). 79% died in the ICU. The highest agreement was between NUTRICm and NUTRICpcr (Kappa= 0.88). The AUCROC (95% CI) to discriminate mortality was: NUTRIC 0.661 (0.598-0.724), NUTRICpcr 0.635 (0.572-0.697) and NUTRICm 0.659 (0.596-0.722). The high RN classification showed differences between the scores with and without an inflammatory biomarker, being significant between NUTRIC and NUTRICm (14.6% vs 22.7%, p 0.0033). Conclusion: In ventilated COVID-19 patients, the three nutritional risk scores studied discriminate mortality in a similar way, but the assessment of high NR differs between them, with a higher prevalence for the NUTRICm, which omits the inflammatory biomarker.