Research Information System
BMC ANESTHESIOLOGY, vol.25, no.1, 2025 (SCI-Expanded, Scopus)
Background: Malnutrition is a prevalent issue in critically ill elderly patients and is closely linked to poor clinical outcomes. This study aimed to assess the prognostic value of four nutritional indices-modified nutrition risk in the critically ill (mNUTRIC), Geriatric Nutritional Risk Index (GNRI), hemoglobin, albumin, lymphocyte, and platelet (HALP), and neutrophil-to-lymphocyte ratio (NLR)-in predicting intensive care unit (ICU) outcomes. Methods: This prospective cohort study included elderly patients (aged >= 65 years) who were admitted to the medical ICU of a tertiary care university hospital. Nutritional indices (mNUTRIC, GNRI, HALP, and NLR) were evaluated for their prognostic value in predicting 28-day mortality, ICU mortality, and ICU length of stay (LOS) using multivariable regression and receiver operating characteristic (ROC) curve analyses. Results: Seventy-three patients were included, with a median age (interquartile range) of 74 (10) years and 56.2% male. The mNUTRIC score was identified as an independent risk factor for 28-day mortality (OR = 2.505, 95%CI: 1.164-5.391, p = 0.019) and ICU mortality (OR = 2.736, 95%CI: 1.350-5.545, p = 0.005), with strong predictive performance (AUC: 0.864 and 0.858, respectively). It was also associated with prolonged ICU LOS (RR = 1.117, 95% CI: 1.033-1.207, p = 0.005). While GNRI exhibited good predictive performance (AUC: 0.811 and 0.799 for 28-day mortality and ICU mortality, respectively), it was not an independent factor. In contrast, HALP and NLR showed limited prognostic value for mortality. Conclusions: The mNUTRIC score was identified as the strongest prognostic tool, with GNRI also demonstrating considerable predictive value for mortality outcomes, enhancing nutritional risk screening and clinical decision-making in elderly ICU patients.