JNCR
Journal of Nursing Care Research

The mission of the journal is to contribute to the development of nursing science and care practices in Turkey and internationally. It is also to promote and disseminate new knowledge and research data for evidence-based care practices at all levels of nursing services. The Journal of Nursing Care Research deals with Fundamentals of Nursing, Internal Medicine Nursing, Surgical Nursing, Obstetrics and Gynecology Nursing, Child Health and Diseases Nursing, Mental Health and Diseases Nursing, Public Health Nursing and Management in Nursing and accepts articles on these topics.

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Original Article
Validation and reliability of the modified NUTRIC score to Turkish: intensive care unit patients
Abstract
Aims: This study aimed to evaluate the psychometric properties of the Turkish version of the modified NUTRIC (mNUTRIC) score among critically ill patients in intensive care units (ICUs).
Methods: Conducted as a methodological study between June 2018 and December 2021, data were collected from 106 patients in the ICUs of two hospitals. The study utilized a patient information form, the mNUTRIC score, and the Nutritional Risk Screening Tool (NRS-2002) for assessment.
Results: The Turkish mNUTRIC score demonstrated robust validity and reliability in patients receiving mechanical ventilation within the first 24 hours of ICU admission. A significant proportion (85.85%) of patients were identified as high risk according to the mNUTRIC score. A strong positive correlation was observed between the mNUTRIC and NRS-2002 scores (p<0.05), confirming the validity of the mNUTRIC score. Additionally, the score exhibited high sensitivity (85.84%) in identifying patients requiring nutritional support.
Conclusion: The Turkish adaptation of the mNUTRIC score has been successfully validated and shown to be a reliable tool for assessing nutritional risk in critically ill ICU patients. Its application can support the timely identification of patients at high nutritional risk and facilitate appropriate interventions.

Keywords : Malnutrition, intensive care, mNUTRIC score, validation, reliability

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Amelia, W. R., Leoni, A. P., Syauqy, A., Laksmi, P. W., Purba, M. B., Noer, E. R., ... &amp; Arini, M. (2023). Malnutrition at hospital admission and its associated factors in internal medicine inpatients. Indonesian J Nutrit, 11(2), 128-139.
Bolayir, B., Arik, G., Yeşil, Y., Kuyumcu, M. E., Varan, H. D., Kara, &Ouml;., ... &amp; Halil, M. G. (2018). Validation of nutritional risk screening-2002 in a hospitalized adult population. Nutr Clin Pract, 34(2), 297-303. doi:10. 1002/ncp.10082
Cattani, A., Eckert, I. C., Brito, J. E., Tartari, R. F., &amp; Silva, F. M. (2020). Nutritional risk in critically ill patients: How it is assessed, its prevalence, and prognostic value: a systematic review. Nutr Rev, 78(12), 1052-1068. doi:10.1093/nutrit/nuaa031
Center, S. R. (2016). Guidelines for best practice in cross-cultural surveys. Survey Research Center, Institute for Social Research, University of Michigan.
Coltman, A., Peterson, S., Roehl, K., Roosevelt, H., &amp; Sowa, D. (2015). Use of 3 tools to assess nutrition risk in the intensive care unit. JPEN J Parenter Enteral Nutr, 39(1), 28-33. doi:10.1177/0148607114532135
Eldehily, K. I., Tawfik, M. F., Elkholy, M. B., &amp; Sabry, S. M. (2023). Impact of malnutrition in critically ill patients on intensive care unit. Egypt J Intensiv Care Emergen Med, 3(1), 57-69. doi:10.21608/jicem.2023.244437. 1024
Gogtay, N. J., &amp; Thatte, U. M. (2017). Principles of correlation analysis. J Assoc Physic India, 65(3), 78-81.
Heyland, D. K., Dhaliwal, R., Jiang, X., &amp; Day, A. G. (2011). Identifying critically ill patients who benefit the most from nutrition therapy: The development and initial validation of a novel risk assessment tool. Crit Care, 15, R268.
Heyland, D. K., Dhaliwal, R., Wang, M., &amp; Day, A. G. (2015). The prevalence of iatrogenic underfeeding in the nutritionally &ldquo;at-risk&rdquo; critically ill patient: results of an international, multicenter, prospective study. Clin Nutr, 34(4), 659-666. doi:10.1016/j.clnu.2014.07.008
Hoffmann, M., Schwarz, C. M., F&uuml;rst, S., Starchl, C., Lobmeyr, E., Sendlhofer, G., &amp; Jeitziner, M. M. (2021). Risks in management of enteral nutrition in intensive care units: a literature review and narrative synthesis. Nutrients, 13(1), 82. doi:10.3390/nu13010082
Kalaiselvan, M. S., Renuka, M. K., &amp; Arunkumar, A. S. (2017). Use of nutrition risk in critically ill (NUTRIC) score to assess nutritional risk in mechanically ventilated patients: a prospective observational study. Indian J Crit Care, 21, 253-256. doi:10.4103/ijccm.IJCCM_24_17
Knaus, W. A., Draper, E. A., Wagner, D. P., &amp; Zimmerman, J. E. (1985). APACHE II: A severity of disease classification system. Crit Care Med, 13(10), 818-829.
Kondrup, J., Rasmussen, H. H., Hamberg, O., &amp; Stanga, Z.; Ad Hoc ESPEN Working Group. (2003). Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 22(3), 321-336. doi:10.1016/S0261-5614(02)00214-5
Lin, P. Y., Yen, Y. T., Lam, C. T., Li, K. C., Lu, M. J., &amp; Hsu, H. S. (2021). Use of modified-NUTRIC score to assess nutritional risk in surgical intensive care unit. J Chin Med Assoc, 84(9), 860-864. doi:10.1097/JCMA. 0000000000000565
Machado dos Reis, A., Marchetti, J., Forte dos Santos, A., Franzosi, O. S., &amp; Steemburgo, T. (2020). NUTRIC score: isolated and combined use with the NRS-2002 to predict hospital mortality in critically ill patients. JPEN J Parenter Enteral Nutr, 44(7), 1250-1256. doi:10.1002/jpen.1804
Mahmoodpoor, A., Sanaie, S., Sarfaraz, T., Shadvar, K., Fattahi, V., Hamishekar, H., ... &amp; Rahimi-Bashar, F. (2023). Prognostic values of modified NUTRIC score to assess outcomes in critically ill patients admitted to the intensive care units: a prospective observational study. BMC Anesthesiol, 23, 131. doi:10.1186/s12871-023-02086-0
Mendes, R., Policarpo, S., Fortuna, P., Alves, M., Virella, D., Heyland, D. K., &amp; Portuguese NUTRIC Study Group. (2017). Nutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients-a multicenter prospective cohort study. J Crit Care, 37, 45-49. doi:10.1016/j.jcrc.2016.08.001
Moreno, R., Vincent, J. L., Matos, R., Mendonca, A., Cantraine, F., Thijs, L., ... &amp; working group on sepsisrelated problems of. (1999). The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care: the results of a prospective, multicenter study. Intensive Care Med, 25, 686-696.
Mishra, S. K., &amp; Kumari, M. (2023). Effect of early enteral nutrition in critically ill patients and their outcomes. Int J Novel Res Devel, 8(6), 373-384.
Mukhopadhyay, A., Henry, J., Ong, V., Leong, C. S. F., Teh, A. L., van Dam, R. M., &amp; Kowitlawakul, Y. (2017). Association of modified NUTRIC score with 28-day mortality in critically ill patients. Clin Nutr, 36, 1143-1148. doi:10.1016/j.clnu.2016.08.004
Nigatu, Y. D., Gebreyesus, S. H., Allard, J. P., &amp; Endris, B. S. (2021). The effect of malnutrition at admission on length of hospital stay among adult patients in developing country: a prospective cohort study. Clin Nutr ESPEN, 41, 217-224. doi:10.1016/j.clnesp.2020.12.013
O&rsquo;meara, D., Mireles-Cabodevila, E., Frame, F., Hummell, A. C., Hammel, J., Dweik, R. A., &amp; Arroliga, A. C. (2008). Evaluation of delivery of enteral nutrition in critically ill patients receiving mechanical ventilation. Am J Crit Care, 17(1), 53-61. doi:10.4037/ajcc2008.17.1.53
Ouaijan, K., Hwalla, N., Kandala, N. B., &amp; Mpinga, E. K. (2023). Prevalence of malnutrition in hospitalized patients in Lebanon using nutrition risk screening (NRS-2002) and Global Leadership Initiative on Malnutrition (GLIM) criteria and its association with length of stay. Healthcare, 11(5), 730. doi:10.3390/healthcare11050730
Pardo, E., Lescot, T., Preiser, J. C., Massanet, P., Pons, A., Jaber, S., ... &amp; Bonnet, M. P. (2023). Association between early nutrition support and 28-day mortality in critically ill patients: the FRANS prospective nutrition cohort study. Crit Care, 27(1), 7. doi:10.1186/s13054-022-04298-1
Preiser, J. C., van Zanten, A. R., Berger, M. M., Biolo, G., Casaer, M. P., Doig, G. S., ... &amp; Vincent, J. L. (2015). Metabolic and nutritional support of critically ill patients: consensus and controversies. Crit Care, 19, 35. doi: 10.1186/s13054-015-0737-8
Rahman, A., Hasan, R. M., Agarwala, R., Martin, C., Day, A. G., &amp; Heyland, D. K. (2016). Identifying critically ill patients who will benefit most from nutritional therapy: further validation of the &ldquo;modified NUTRIC&rdquo; nutritional risk assessment tool. Clin Nutr, 35, 158-162. doi:10. 1016/j.clnu.2015.01.015
Rattanachaiwong, S., Zribi, B., Kagan, I., Theilla, M., Heching, M., &amp; Singer, P. (2020). Comparison of nutritional screening and diagnostic tools in diagnosis of severe malnutrition in critically ill patients. Clin Nutr, 39(11), 3419-3425. doi:10.1016/j.clnu.2020.02.035
Reis, A. M. D., Fructhenicht, A. V. G., &amp; Moreira, L. F. (2019). NUTRIC score use around the world: a systematic review. Rev Bras Ter Intensiva, 31, 379-385. doi:10.5935/0103-507X.20190061
Rosa, M., Heyland, D. K., Fernandes, D., Rabito, E. I., Oliveira, M. L., &amp; Marcadenti, A. (2016). Translation and adaptation of the NUTRIC score to identify critically ill patients who benefit the most from nutrition therapy. Clin Nutr ESPEN, 14, 31-36. doi:10.1016/j.clnesp.2016.04.030
Santana dos Santos, I. K., Borges dos Santos Pereira, D., Cumpian Silva, J., de Oliveira Gallo, C., de Oliveira, M. H., Pereira de Vasconcelos, L. C., &amp; Conde, W. L. (2024). Frequency of anthropometric implausible values estimated from different methodologies: a systematic review and meta-analysis. Nutr Rev, 82(11), 1514-1523. doi:10.1093/nutrit/nuad142
Smith, L. O., Olieman, J. F., Berk, K. A., Ligthart-Melis, G. C., &amp; Earthman, C. P. (2023). Clinical applications of body composition and functional status tools for nutrition assessment of hospitalized adults: a systematic review. JPEN J Parenter Enteral Nutr, 47(1), 11-29. doi:10.1002/jpen.2444
Trevethan, R. (2017). Sensitivity, specificity, and predictive values: Foundations, pliabilities, and pitfalls in research and practice. Front Public Health, 5, 307. doi:10.3389/fpubh.2017.00307
Tuyishime, E., Niyongombwa, I., Karenzi, I. D., Bisimwa, J. D. A., Uwineza, J. B., Ntirenganya, F., ... &amp; Rickard, J. (2022). Prevalence of malnutrition and associated risk factors among patients admitted to the intensive care unit of a tertiary university teaching hospital in Kigali, Rwanda: a cross-sectional study. East Cent Afr J Surg, 27(1), 10-17. doi:10.4314/ecajs.v27i1.2
Ukleja, A. (2010). Altered GI motility in critically ill patients: current understanding of pathophysiology, clinical impact, and diagnostic approach. Nutr Clin Pract, 25(1), 16-25. doi:10.1177/0884533609357568
Valter, R., Paillaud, E., Boudou-Rouquette, P., Oubaya, N., Ar&eacute;gui, A., Lorisson, E., ... &amp; Martinez-Tapia, C. (2024). Comparison of the prognostic value of eight nutrition-related tools in older patients with cancer: a prospective study. J Nutr Health Aging, 28(4), 100188. doi:10. 1016/j.jnha.2024.100188
de Vries, M. C., Koekkoek, W. A. C., Opdam, M. H., van Blokland, D., &amp; van Zanten, A. R. (2018). Nutritional assessment of critically ill patients: validation of the modified NUTRIC score. Eur J Clin Nutr, 72(3), 428-435. doi:10.1038/s41430-017-0008-7
Wang, H., Wang, B., Zhang, X., &amp; Feng, C. (2021). Relations among sensitivity, specificity, and predictive values of medical tests based on biomarkers. Gen Psychiatry, 34(2), e100453. doi:10.1136/gpsych-2020- 100453
Warren, M., McCarthy, M. S., &amp; Roberts, P. R. (2016). Practical application of the revised guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: a case study approach. Nutr Clin Pract, 31, 334-341. doi:10.1177/0884533616640451 </ol> <p>
Article available in :
Volume 2, Issue 2, 2025
Page : 37-42
https://doi.org/10.51271/JNCR-0027
Article Information
Received : 19 Mar 2025
Accepted : 29 May 2025
Published : 25 Haz 2025
Corresponding Author :

Hülya Saray Kılıç: Department of Nursing, Faculty of Health Science, Bilecik Şeyh Edebali University, Bilecik, Turkiye

[email protected]
Citation : Saray Kılıç, H., Özen, N., Özden, E., Yeşilfidan, C., Özen, V., Yamanel, L., ... & Terzioğlu, F. (2025). Validation and reliability of the modified NUTRIC score to Turkish: intensive care unit patients. J Nurs Care Res, 2(2), 37-42.

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