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

Qiqing Gao,&ast; Yao Cheng,&ast; Zhuohong Li, Qingyun Tang, Rong Qiu, Shaohang Cai, Xuwen Xu, Jie Peng, Hongyan Xie Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jie Peng; Hongyan XieDepartment of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of ChinaTel +86 20 62787428Fax +86 20 87719653Email pjie138@163.com; 492577598@qq.comBackground: 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