Evidence map›Paper›PMID 40394257›Full record

Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Association of modified NUTRIC score for nutritional risk and in-hospital developed malnutrition in adults with severe injuries: a prospective observational cohort study.

Esmee A H Verheul, Dylan Koole, Suzan Dijkink, Pieta Krijnen, Jochem M Hoogendoorn, Sesmu Arbous, Ron Peters, George C Velmahos, Ali Salim, Daniel D Yeh and 1 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Esmee A H VerheulDepartment of Trauma Surgery, Leiden University Medical Center, Post zone K6-R, P.O. Box 9600, Leiden, 2300, RC, The Netherlands. e.a.h.verheul@lumc.nl.
Dylan KooleDepartment of Trauma Surgery, Leiden University Medical Center, Post zone K6-R, P.O. Box 9600, Leiden, 2300, RC, The Netherlands.
Suzan DijkinkDepartment of Trauma Surgery, Leiden University Medical Center, Post zone K6-R, P.O. Box 9600, Leiden, 2300, RC, The Netherlands.
Pieta KrijnenDepartment of Trauma Surgery, Leiden University Medical Center, Post zone K6-R, P.O. Box 9600, Leiden, 2300, RC, The Netherlands.
Jochem M HoogendoornDepartment of General Surgery, Haaglanden Medical Center, The Hague, The Netherlands.
Sesmu ArbousDepartment of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands.
Ron PetersDepartment of Intensive Care, Haaglanden Medical Center, The Hague, The Netherlands.
George C VelmahosDepartment of Trauma Surgery, Massachusetts General Hospital, Boston, MA, USA.
Ali SalimDepartment of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Daniel D YehDepartment of Surgery, Denver Health Medical Center, Denver, CO, USA.
Inger B SchipperDepartment of Trauma Surgery, Leiden University Medical Center, Post zone K6-R, P.O. Box 9600, Leiden, 2300, RC, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study investigated the prevalence of high nutritional risk (modified Nutrition Risk in Critically Ill (mNUTRIC) score ≥ 5) and its relation with malnutrition and other adverse in-hospital outcomes in severely injured patients (Injury Severity Score ≥ 16), admitted to the ICU. We hypothesized that high nutritional risk is associated with an increased risk of developing malnutrition (primary hypothesis) and of complications and mortality (secondary hypotheses) in adults with severe injuries compared to those with low nutrition risk.

methodsIn this observational prospective study, 100 severely injured patients admitted to the ICU of five Level-1 trauma centers in the US and the Netherlands between 2018-2022 were included. During ICU and hospital stay, malnutrition rates (Subjective Global Assessment score ≤ 5), complication rates (systemic complications, pneumonia, urinary tract infection, venous thromboembolism), and mortality of severely injured patients with high versus low nutritional risk were compared. A cause-specific Cox regression model was fitted to analyze whether high nutritional risk was related to developing malnutrition.

resultsEighteen percent of patients had high nutritional risk (95% confidence interval [CI] 10.5-25.5%) at admission. High nutritional risk was not related to in-ICU or in-hospital developed malnutrition. In patients with high nutritional risk, the hazard ratio for developing malnutrition was 1.3 (95% CI 0.7-2.6, p = 0.45). Severely injured patients with high nutritional risk had more complications during ICU (78% vs 29%, p < 0.001; OR 8.5, 95% CI 2.5-28.3) and hospital stay (83% vs 41%, p < 0.01; OR 6.0, 95% CI 1.5-24.9). ICU mortality (22% vs 4%, p = 0.02; OR 7.5, 95% CI 1.5-37.3) and hospital mortality (33% vs 6%, p < 0.01; OR 5.9, 95% CI 1.3-26.4) were also higher in patients with high nutritional risk.

conclusionAbout one-fifth of severely injured patients admitted to the ICU had high nutritional risk. High nutritional risk in severely injured patients is not associated with malnutrition. It is potentially associated with adverse in-hospital outcomes. LEVEL OF EVIDENCE: Level III, Prognostic/Epidemiological.

Indexed as

MalnutritionNutrition AssessmentWounds and InjuriesAdultAgedCritical IllnessFemaleHospital MortalityHumansInjury Severity ScoreIntensive Care UnitsLength of StayMaleMiddle AgedNetherlandsNutritional StatusComplicationsIntensive care unitNutritional riskSeverely injuredTrauma

Identifiers

PMID40394257
PMCPMC12092562

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.