Nutrition Risk in the Critically Ill (NUTRIC) Score
Screens critically ill patients at risk who can benefit from nutrition therapy.
Refer to the text below the calculator for more information about the NUTRIC Score and the original study.
The Nutrition Risk in the Critically Ill (NUTRIC) Score is recommended by the American College of Gastroenterology (ACG) guidelines for nutrition therapy and can be safely used to identify critically ill patients at risk of malnutrition and 28-day mortality.
Compared to the other nutritional risk scores, such as the NRS-2002, NUTRIC was found to have a greater predictive power in screening intensive care unit patients who could benefit from nutrition therapy.
NUTRIC Score | Risk | 28-day mortality (appx) |
0 | Low risk | 1% |
1 | 2% | |
2 | 3% | |
3 | 8% | |
4 | 11% | |
5 | 20% | |
6 | High risk | 30% |
7 | 45% | |
8 | 58% | |
9 | 70% | |
10 | 80% |
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NUTRIC Score Explained
The nutrition Risk in the Critically Ill (NUTRIC) Score is recommended by the American College of Gastroenterology (ACG) guidelines for nutrition therapy and can be safely used to identify critically ill patients at risk of malnutrition and 28-day mortality.
The score consists in six items, and accounts for patient age, number of comorbidities, how long the patient has been admitted to ICU, their APACHE II and SOFA scores on presentation and their level of Interleukin 6 (which, if unknown, may be excluded from the score).
NUTRIC Score items | Answer choices | Pts |
Age | <50 | 0 |
50 - 74 | 1 | |
≥75 | 2 | |
APACHE II Score | <15 | 0 |
15 - 19 | 1 | |
20 - 27 | 2 | |
≥28 | 3 | |
SOFA Score on presentation | <6 | 0 |
6 - 9 | 1 | |
≥10 | 2 | |
Number of comorbidities | 0 - 1 | 0 |
≥2 | 1 | |
Days in hospital to ICU admission | 0 | 0 |
≥1 | 1 | |
IL-6, µ/mL | 0 – 399 | 0 |
≥400 | 1 |
Compared to the other nutritional risk scores, such as the NRS-2002, NUTRIC was found to have a greater predictive power in screening intensive care unit patients who could benefit from nutrition therapy.
NUTRIC scores range from 0 to 10, where the higher the score, the greater the malnutrition and mortality risk:
NUTRIC Score | Risk | 28-day mortality (appx) |
0 | Low risk | 1% |
1 | 2% | |
2 | 3% | |
3 | 8% | |
4 | 11% | |
5 | 20% | |
6 | High risk | 30% |
7 | 45% | |
8 | 58% | |
9 | 70% | |
10 | 80% |
Heyland et al. performed an observational study of 597 ICU patients expected to be admitted for more than 24 hours. Several clinical data was collected, that included, aside from the six items of the score, Body Mass Index (where <20), estimated % oral intake in the week prior, weight loss in the last 3 months, procalcitonin (PCT), and C-reactive protein (CRP) levels.
The six final items were drawn based on the statistical significance in the multivariable model and can be used in the scoring algorithm to identify ICU patients that are most likely to benefit from aggressive nutrition therapy.
References
Original reference
Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care. 2011; 15(6):R268.
Validation
Rahman A, Hasan RM, Agarwala R, Martin C, Day AG, Heyland DK. Identifying critically-ill patients who will benefit most from nutritional therapy: Further validation of the "modified NUTRIC" nutritional risk assessment tool. Clin Nutr. 2016; 35(1):158-162.
Other references
McClave SA, DiBaise JK, Mullin GE, Martindale RG. ACG Clinical Guideline: Nutrition Therapy in the Adult Hospitalized Patient. Am J Gastroenterol. 2016; 111(3):315-335.
Specialty: Internal Medicine
Objective: Risk Predictor
Year Of Study: 2011
Abbreviation: NUTRIC
Article By: Denise Nedea
Published On: November 11, 2020 · 12:00 AM
Last Checked: November 11, 2020
Next Review: November 11, 2025