title: Increased nutritional risk in major trauma: correlation with complications and prolonged length of stay.
abstract: BACKGROUND
  Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Trauma Injury Severity Score (TRISS) are physiological and anatomical severity scores to predict trauma outcome. Nutritional Risk Screening (NRS-2002) is used for the screening of nutritional risk, which can affect outcome adversely. The objective of this study was to determine the reliability of these scales to predict disease severity, complications and mortality, and to compare the reliability of the NRS-2002 in predicting outcome with different scoring systems in trauma-intensive care unit (ICU) patients.
  
  
  METHODS
  The study enrolled 100 consecutive patients who were admitted to the ICU in a training hospital due to trauma in the six-month study period (1 July 2008 and 1 January 2009). Discrimination characteristics of the scoring systems were evaluated using receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  Overall mortality was 14%, and the complication rate was 22%. Nutritional risk at admission was found to be increased in 58% of the patients. The NRS-2002 score was increased in patients with complication. ISS, TRISS and APACHE II at admission had a reliable power of discrimination (AUC>0.8) for mortality and complication prediction. The NRS-2002 score had moderate discrimination power for complication prediction (AUC=0.708) but showed high correlation with increased length of stay (LOS).
  
  
  CONCLUSIONS
  A significant percent of trauma patients are at nutritional risk. The NRS-2002 score can be useful in predicting complication and prolonged LOS in trauma patients.
authors.affiliation: Department of Emergency Medicine, Adana Numune Training and Research Hospital, Adana, Turkey. drzikret@yahoo.com
authors.forename: Zikret
authors.initials: Z
authors.lastname: Köseoğlu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozdoğan
authors.forename: Adnan
authors.initials: A
authors.lastname: Kuvvetli
authors.forename: Ozgün
authors.initials: O
authors.lastname: Kösenli
authors.forename: Cem
authors.initials: C
authors.lastname: Oruç
authors.forename: Safa
authors.initials: S
authors.lastname: Onel
authors.forename: Koray
authors.initials: K
authors.lastname: Das
authors.forename: Atilla
authors.initials: A
authors.lastname: Akova
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009104:Multiple Trauma / Q000145:classification* / Q000453:epidemiology* / Q000401:mortality; D018529:Nutritional Support; D015599:Trauma Severity Indices; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult