Association Between Nutritional Risk Screening Score and Prognosis of Patients with Sepsis

Abstract

Background

Malnutrition is one of the most critical factors affecting patients’ risk of infection and length of stay, and it may affect the prognosis of patients with sepsis. There have been no studies that have applied nutritional risk screening tools to stratify patients with sepsis according to prognosis.

Methods

We retrospectively analyzed the clinical data of 425 adult sepsis inpatients who were grouped based on nutritional risk screening (NRS) score, including a nutrition score, disease severity score, and age score. Prognostic factors were analyzed using univariate and multivariate regression analyses.

Results

Of the enrolled patients, 174 had an NRS score of ≥3; these patients were older and had a longer hospitalization time but lower body mass index (BMI), albumin (ALB) than others. Univariate Cox regression analysis showed that age, ALB, C-reactive protein (CRP), and NRS score were significantly (P<0.05) associated with in-hospital mortality. Multivariate analysis showed that age (hazard ratio [HR]=1.020, 95% confidence interval [CI]: 1.005–1.036; P=0.008) and ALB (HR=0.924, 95% CI: 0.885–0.966; P<0.001) were independent risk factors for sepsis-related mortality. The Kaplan–Meier analysis revealed that the cumulative in-hospital mortality of sepsis patients with an NRS score of ≥3 was significantly higher than that of patients with an NRS score of <3 (P=0.022).

Conclusion

NRS scores can effectively risk stratify sepsis patients. Patients with high NRS scores should be monitored more closely to halt further disease progression.

Keywords:

• sepsis
• malnutrition
• NRS
• risk stratification
• prognostic assessment

Availability of Supporting Data

Authors can confirm all relevant data are included in the article and materials are available on request from the authors.

Ethics Approval and Consent to Participate

This retrospective study was approved by the Institutional Review Board/Independent Ethics Committee of Nanfang Hospital of Southern Medical University, and the need for informed consent was waived since all data were anonymized before analysis. Patient privacy and confidentiality of data were maintained in accordance with the Declaration of Helsinki.

Disclosure

Qiqing Gao and Yao Cheng are co-first authors for this study. The authors declare that they have no conflicts of interest.