Nutritional Risk Screening as a Prognostic Factor for Emergency Department Patients with Severe Sepsis

ABSTRACT

PURPOSE: This study was aimed at determining if nutritional risk is associated with increased mortality in severe sepsis patients, and whether or not nutritional risk screening is helpful when assessing mortality risk for these patients in the Emergency Department (ED). METHODS: We conducted an observational study using adult patients (> or =18 years of age) with severe sepsis who were admitted to the ED in a tertiary teaching hospital during a 12-month period. Participant data collected included demographics, sepsis severity scale, laboratory test results and nutritional risk screening results. We divided the patients into two groups: survivors and non-survivors. The endpoint was 28-day hospital mortality. RESULTS: A total of 204 patients participated in this study and 166 had survived and 38 had died by the endpoint. The two participant groups differed with regards to age, gender, Sequential Organ Failure Assessment (SOFA) score, Nutritional Risk Screening Tool (NRST) score, presence of cancer, serum creatinine level, and arterial lactate level. According to the multivariate logistic regression analysis results, the most significant variables for prognosis were the SOFA score (p=0.027), NRST score (p=0.001) and arterial lactate level (p=0.001). CONCLUSION: In ED patients with severe sepsis, nutritional risk is related to 28-day hospital mortality. Nutritional risk screening may be helpful for risk stratification of severe sepsis patients.