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Original Article
- Nutrition
- Comparative prognostic performance of nutritional assessment tools in critically ill surgical patients after emergency surgery for sepsis or septic shock: a single-center retrospective study in South Korea
- Sung Bak An, Dong Woo Shin
- Acute Crit Care. 2026;41(2):399-410. Published online May 28, 2026
- DOI: https://doi.org/10.4266/acc.001170
- 781 View
- 18 Download
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Abstract
PDF - Background
Malnutrition is prevalent in critically ill patients. Although various nutritional assessment tools are used in intensive care units (ICUs), their comparative prognostic performance in critically ill surgical patients requiring postoperative ICU care after emergency surgery for sepsis or septic shock remains uncertain. We compared the performance of four tools in predicting ICU mortality. Methods: We retrospectively analyzed 218 adult critically ill surgical patients requiring postoperative ICU care after emergency surgery for sepsis or septic shock (January 2015–July 2025). Nutritional status was assessed within 24 hours of ICU admission using the Global Leadership Initiative on Malnutrition (GLIM), modified Nutrition Risk in the Critically Ill (mNUTRIC), Nutritional Risk Screening 2002 (NRS-2002), and Malnutrition Universal Screening Tool (MUST). The primary outcome was ICU mortality. Discriminative performance was evaluated using the area under the receiver operating characteristic curve and incremental value over a baseline model (age, sex, Acute Physiology and Chronic Health Evaluation [APACHE] II score, and Sequential Organ Failure Assessment [SOFA] score). Results: The mNUTRIC score showed the highest crude discrimination for ICU mortality, followed by MUST and GLIM, whereas NRS-2002 demonstrated limited discriminatory ability. When added to the baseline clinical model, MUST and GLIM improved mortality prediction, unlike mNUTRIC. Higher risk categories in MUST and GLIM were associated with increased ICU mortality. Conclusions: Prognostic performance varies among nutritional assessment tools. MUST and GLIM provide prognostic information beyond conventional severity scores, whereas the prognostic value of mNUTRIC is largely driven by disease severity, supporting their use for risk stratification in critically ill surgical patients.
Corrigendum
- Trauma
- Risk factor, monitoring, and treatment for snakebite induced coagulopathy: a multicenter retrospective study
- Yong Jun Jeon, Jong Wan Kim, SungGil Park, Dong Woo Shin
- Acute Crit Care. 2020;35(1):56-56. Published online February 29, 2020
- DOI: https://doi.org/10.4266/acc.2019.00591.e1
- Corrects: Acute Crit Care 2019;34(4):269
- 5,539 View
- 106 Download
- 1 Web of Science
Original Article
- Trauma
- Risk factor, monitoring, and treatment for snakebite induced coagulopathy: a multicenter retrospective study
- Yong Jun Jeon, Jong Wan Kim, SungGil Park, Dong Woo Shin
- Acute Crit Care. 2019;34(4):269-275. Published online November 18, 2019
- DOI: https://doi.org/10.4266/acc.2019.00591
- Correction in: Acute Crit Care 2020;35(1):56
- 13,023 View
- 192 Download
- 15 Web of Science
- 18 Crossref
-
Abstract
PDF
- Background
Snakebite can cause various complications, including coagulopathy. The clinical features of snakebite-associated coagulopathy differ from those of disseminated intravascular coagulation (DIC) caused by other diseases and its treatment is controversial.
Methods
We retrospectively reviewed the medical records of patients hospitalized for snakebite between January 2006 and September 2018.
Results
A total of 226 patients were hospitalized due to snakebite. Their median hospital stay was 4.0 days (interquartile range, 2.0 to 7.0 days). Five patients arrived at hospital with shock and one patient died. Twenty-one patients had overt DIC according to the International Society of Thrombosis and Hemostasis scoring system. Two patients developed major bleeding complications. Initial lower cholesterol level at presentation was associated with the development of overt DIC. International normalization ratio (INR) exceeding the laboratory’s measurement limit was recorded as late as 4 to 5 days after the bite. Higher antivenom doses (≥18,000 units) and transfusion of fresh frozen plasma (FFP) or cryoprecipitate did not affect prolonged INR duration or hospital stay in the overt DIC patients without bleeding.
Conclusions
Initial lower cholesterol level may be a risk factor for overt DIC following snakebite. Although patients lack apparent symptoms, the risk of coagulopathy should be assessed for at least 4 to 5 days following snakebite. Higher antivenom doses and transfusion of FFP or cryoprecipitate may be unbeneficial for coagulopathic patients without bleeding. -
Citations
Citations to this article as recorded by
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