PP346 - ARE WE MISSING THE PATIENT BEHIND THE SCORE? NUTRIC AND METABOLIC–CELLULAR MISMATCH IN CRITICALLY ILL PACIENTS
PP346
ARE WE MISSING THE PATIENT BEHIND THE SCORE? NUTRIC AND METABOLIC–CELLULAR MISMATCH IN CRITICALLY ILL PACIENTS
I. Ciomag1,*, C. Cobilinschi1,2, A. M. Dumitriu1,2, R. Darie1,2, A. C. Andrei1,2, E. Moisa2,3, N. Tanase2,4, L. Mirea1,2
1Anesthesiology and Intensive Care Clinic, Clinical Emergency Hospital of Bucharest, 2Carol Davila University of Medicine and Pharmacy, 3Anesthesiology and Intensive Care Clinic, Elias Emergency University Hospital, 4Anesthesiology and Intensive Care Clinic, The Central Military University Emergency Hospital, Bucharest, Romania
Rationale: The NUTRIC score is a well-established tool for nutritional risk stratification in critically ill patients (1). However, its ability to reflect underlying cellular integrity and metabolic demand remains uncertain (2–4).
Methods: Fifty critically ill, mechanically ventilated patients admitted to the intensive care unit (ICU) underwent bedside bioelectrical impedance analysis using a tetrapolar technique to estimate body composition, with phase angle (PA) derived as a marker of cellular integrity. Indirect calorimetry was performed under steady-state conditions, measuring oxygen consumption and carbon dioxide production to calculate resting energy expenditure (EE) (5). The NUTRIC score was calculated at ICU admission. Associations between NUTRIC, PA, and EE were evaluated using Spearman correlation coefficients.
Results: No significant association was observed between NUTRIC and PA (ρ=−0.017, p=0.906), nor between NUTRIC and EE (ρ=−0.083, p=0.567). Among high-risk patients (NUTRIC ≥6), 38.5% survived at 28 days, representing 20.0% of the cohort, with a mean PA of 4.18 (range 1.2–9.0) and EE of 1562 kcal (range 1073–1859 kcal), indicating that elevated nutritional risk did not uniformly translate into adverse outcomes. The wide dispersion of PA values further highlights the heterogeneity of cellular integrity among patients with similar risk profiles.
Conclusion: While NUTRIC identifies patients at increased risk, it does not capture key physiological dimensions such as cellular integrity and metabolic variability. The observed dissociation among high-risk survivors supports integrating PA and EE for a more nuanced, patient-centered assessment (2–4).
References: 1.Singer P, Reintam Blaser A, Berger MM, et al. Clin Nutr. 2023;42
2.Yang J, et al. Front Nutr. 2024;11
3.Papanastasiou P, et al. Nutrients. 2025;17
4.Tatucu-Babet OA, et al. Curr Opin Clin Nutr Metab Care. 2023;26
5.Oshima T, et al. Clin Nutr. 2022;41
Disclosure of Interest: None declared