Citation: Welna, M.; Adamik, B.; Kübler, A.; Go´ zdzik, W. The NUTRIC Score as a Tool to Predict Mortality and Increased Resource Utilization in Intensive Care Patients with Sepsis. Nutrients 2023, 15, 1648. https:// doi.org/10.3390/nu15071648 Academic Editors: George Briassoulis, Panagiotis Briassoulis and Stavroula Ilia Received: 26 February 2023 Revised: 24 March 2023 Accepted: 26 March 2023 Published: 28 March 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). nutrients Article The NUTRIC Score as a Tool to Predict Mortality and Increased Resource Utilization in Intensive Care Patients with Sepsis Marek Welna 1, *, Barbara Adamik 1 , Andrzej Kübler 2 and Waldemar Go´ zdzik 1 1 Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, 50-556 Wroclaw, Poland 2 Department of Anesthesiology and Intensive Therapy, Wroclaw University Hospital, 50-556 Wroclaw, Poland * Correspondence: marek.welna@umw.edu.pl Abstract: The Nutrition Risk in Critically Ill score (NUTRIC) is an important nutritional risk as- sessment instrument for patients in the intensive care unit (ICU). The purpose of this study was to evaluate the power of the score to predict mortality in patients treated for sepsis and to forecast in- creased resource utilization and nursing workload in the ICU. The NUTRIC score predicted mortality (AUC 0.833, p < 0.001) with the optimal cut-off value of 6 points. Among patients with a score ≥ 6 on ICU admission, the 28-day mortality was 61%, and 10% with a score < 6 (p < 0.001). In addition, a NUTRIC score of ≥6 was associated with a more intense use of ICU resources, as evidenced by a higher proportion of patients requiring vasopressor infusion (98 vs. 82%), mechanical ventilation (99 vs. 87%), renal replacement therapy (54 vs. 26%), steroids (68 vs. 31%), and blood products (60 vs. 43%); the nursing workload was also significantly higher in this group. In conclusion, the NUTRIC score obtained at admission to the ICU provided a good discriminative value for mortality and makes it possible to identify patients who will ultimately require intense use of ICU resources and an associated increase in the nursing workload during treatment. Keywords: intensive care; sepsis; nutrition; mortality prediction 1. Introduction The NUTRIC score (nutrition risk in the critically ill) is a risk assessment tool. It was developed for use in patients treated in the intensive care unit (ICU) in order to help identify those who would benefit most from nutritional therapy [1]. The benefit of using the tool is estimated by calculating the change in the survival rate; a lower NUTRIC score is associated with lower mortality, which has been confirmed in various groups including critically ill COVID-19 patients [2,3], mechanically ventilated ICU patients [4,5] patients after cardiothoracic surgery treated in a recovery unit [6], and in patients with severe community-acquired pneumonia [7]. The conceptual model used to develop the NUTRIC score was complex and consisted of parameters describing chronic and acute inflammation, age, general clinical assessment, organ failure assessment, and markers of acute and chronic starvation. The model was externally validated and a good discrimination confirmed its predictive ability [8]. Several further studies have shown an association between the NUTRIC score and ICU mortality and it has been observed that, especially patients with high NUTRIC scores may benefit from optimal nutrition, thus improving survival. [9–11]. Validation of the NUTRIC score can be seen primarily in the impact on 28-day mortality or the requirement for prolonged mechanical ventilation in ICU patients [1,12]. However, the relationship between the score and the need to use other ICU resources has not been assessed. A group of patients who require a much greater use of resources during an ICU/hospital stay are patients with sepsis [13,14]. The analysis done by Jones et al. showed that patients hospitalized for sepsis consumed significantly more hospital resources over a 12-month period compared to patients hospitalized for diseases other than sepsis [15]. Full Nutrients 2023, 15, 1648. https://doi.org/10.3390/nu15071648 https://www.mdpi.com/journal/nutrients