Comparative Analysis of Four Nutritional Scores in Predicting Hospital Stay Duration for EICU Patients with Acute Pancreatitis

Why It Matters

Identifying patients at risk of prolonged hospitalization enables targeted nutrition therapy, potentially reducing ICU resource use and improving recovery in acute pancreatitis.

Key Takeaways

• NRS‑2002 independently predicts longer EICU stays in acute pancreatitis.
• Each NRS‑2002 point adds about three days to hospital stay.
• AUC of 0.813 indicates strong discriminative ability for NRS‑2002.
• CONUT and PNI are not independent predictors after adjustment.
• Implementing NRS‑2002 screening may enable earlier nutritional support.

Pulse Analysis

Nutritional status is a pivotal determinant of outcomes in critically ill patients, especially those battling acute pancreatitis, where hypermetabolism and protein catabolism accelerate malnutrition. Traditional assessment tools—PNI, CONUT, and the newer TCBI—rely heavily on laboratory values that can fluctuate rapidly during the acute phase, limiting their reliability for early risk stratification. In contrast, the Nutritional Risk Screening 2002 (NRS‑2002) incorporates both dietary intake and disease severity, offering a more holistic view of a patient’s physiological reserve at the point of admission.

The study’s multivariate analysis highlighted NRS‑2002 as the sole score retaining statistical significance after adjusting for age, comorbidities, and severity indices such as APACHE II and SOFA. With an adjusted mean difference of nearly three days per NRS‑2002 point and an area under the ROC curve of 0.813, the tool demonstrates robust predictive power for prolonged hospital stays. By comparison, CONUT and PNI lost significance once confounders were accounted for, and TCBI showed no meaningful association, underscoring the limitations of purely biochemical indices in the volatile early course of pancreatitis.

From an operational standpoint, integrating NRS‑2002 into admission protocols could streamline the identification of patients who would benefit from aggressive early nutrition, such as enteral feeding within 48 hours—a strategy linked to reduced complications in severe pancreatitis. While the single‑center, retrospective design constrains generalizability, the findings provide a compelling case for prospective multicenter trials to assess whether NRS‑2002‑guided nutrition interventions translate into shorter ICU stays, lower costs, and improved survival. Health systems aiming to optimize resource allocation should consider adopting systematic NRS‑2002 screening as a low‑cost, high‑impact measure.