PP344
BEYOND TRADITIONAL CRITICAL CARE SCORES: THE SUPERIORITY OF THE M-NUTRIC SCORE IN PREDICTING MORTALITY AND SEVERE COMPLICATIONS AFTER EMERGENCY SURGERY FOR HOLLOW ORGAN PERFORATION
C.-W. Huang1,*
1General Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan, Province of China
Rationale: Hollow organ perforation (HOP) is a surgical emergency triggering sepsis and rapid nutritional depletion. Traditional scoring systems (APACHE II, SOFA) lack baseline nutritional assessments. The m-NUTRIC score integrates acute disease severity with nutritional vulnerability. This study investigated the predictive value of m-NUTRIC for severe complications (Clavien-Dindo [CD] ≥ 3) and 30-day mortality in critically ill HOP patients, comparing it with APACHE II and SOFA.
Methods: A retrospective study at a Taiwan tertiary hospital (2020-2023) enrolled adults requiring emergency HOP surgery and intensive care unit admission. Endpoints were CD ≥ 3 complications and 30-day mortality. Independent predictors were identified via multivariable logistic regression. Discriminative abilities were evaluated using ROC curve analysis.
Results: 73 patients (mean age 68.86 ± 14.4 years) were included. CD ≥ 3 complication incidence was 41.1%; 30-day mortality was 13.7%. Multivariable regression identified high m-NUTRIC score (Adjusted OR 3.874, 95% CI: 1.255-11.958, p=0.019) and preoperative shock (Adjusted OR 3.716, p=0.035) as independent predictors of severe complications. For 30-day mortality, m-NUTRIC exhibited superior discriminative power (AUC=0.850) versus APACHE II (AUC=0.763) and SOFA (AUC=0.756). An m-NUTRIC cut-off ≥ 6 yielded high specificity for CD ≥ 3 (93.0%) and mortality (87.3%).
Image:
Conclusion: The m-NUTRIC score is a highly accurate independent predictor of severe complications and mortality in emergency HOP surgery. It significantly outperformed traditional APACHE II and SOFA scores. Routine use of an m-NUTRIC cut-off ≥ 6 is recommended as a highly specific tool for early risk stratification and targeted nutritional therapy.
Disclosure of Interest: None declared