Translation of the modified NUTRIC score and adaptation to the Greek ICU setting

Michael Chourdakis; Maria G Grammatikopoulou; Kalliopi Anna Poulia; Marili Passakiotou; Zoe K Pafili; Emmanouil Bouras; Ioannis Doundoulakis; Ioannis Galitsianos; Theodora Lappa; Anestis Karakatsanis; Daren K Heyland

doi:10.1016/j.clnesp.2018.12.003

Translation of the modified NUTRIC score and adaptation to the Greek ICU setting

Clin Nutr ESPEN. 2019 Feb:29:72-76. doi: 10.1016/j.clnesp.2018.12.003. Epub 2018 Dec 29.

Affiliations

¹ Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address: mhourd@gapps.auth.gr.
² Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
³ Department of Nutrition and Dietetics, Laiko General Hospital, Athens, Greece.
⁴ Intensive Care Unit, Hippokration University Hospital, Thessaloniki, Greece.
⁵ Department of Nutrition and Dietetics, Achilopoulio General Hospital, Volos, Greece.
⁶ Intensive Care Unit, Department of Anesthesiology, A.H.E.P.A University Hospital, Aristotle University of Thessaloniki, Greece.
⁷ Department of Nutrition and Dietetics, KAT General Hospital of Athens, Greece.
⁸ Intensive Care Unit, General Hospital "Ag. Pavlos", Thessaloniki, Greece.
⁹ Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada; Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada.

PMID: 30661704
DOI: 10.1016/j.clnesp.2018.12.003

Abstract

Background & aims: Patients in the intensive care unit are experiencing an increased malnutrition risk. The NUTrition Risk in the Critically ill score (NUTRIC) is a validated tool for the identification of patients that will benefit the most, from nutritional intervention. The aim of the study was twofold, including: 1) to translate and adapt the NUTRIC score in the Greek language for more efficient and comprehensive use among clinicians, and 2) to assess its prognostic performance in a pilot sample.

Methods: The translation process followed standardized steps: 1) initial translation, 2) synthesis of different translations, 3) back -translation to the English language, 4) revision and cultural adaptation of the instrument by an expert committee. A pilot application study was conducted on 80 critically ill patients from three ICUs in Greek hospitals. The NUTRIC score was calculated using the final translated version.

Results: The translated score was considered easy to use, fast and comprehensive. No specific corrections were suggested by the expert committee. According to the translated version of the score 56% of the screened patients were classified as of high nutritional risk (score between 5 and 9). Compared to the low - NUTRIC patients, high - NUTRIC patients were older (56.4 ± 16.4 vs. 68.7 ± 12.7 yrs, p < 0.001), had increased APACHE (13.8 ± 6.5 vs. 23.8 ± 6.5, p < 0.001) and SOFA scores (4.7 ± 3.1 vs. 10.4 ± 3.1, p < 0.001) and demonstrated more comorbidities. Elevated 28 -day mortality was observed among high -NUTRIC patients compared to the low - NUTRIC ones (6 vs. 18 patients, p < 0.05).

Conclusions: The Greek version of the NUTRIC score is ready for use among health care professionals employed in intensive care units in Greek speaking countries, aiming to discriminate critically ill patients benefiting from enhanced nutritional support.

Keywords: Greek; ICU; Malnutrition; Mortality; NUTRIC; Nutritional support; Screening; Translation.

MeSH terms

APACHE
Adult
Aged
Aged, 80 and over
Comorbidity
Critical Illness / mortality*
Female
Greece
Hospital Mortality
Humans
Intensive Care Units*
Language
Male
Malnutrition / complications*
Middle Aged
Nutritional Status*
Nutritional Support
Organ Dysfunction Scores
Risk Assessment
Surveys and Questionnaires
Translations*