ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1482150
Comparative Analysis of Four Nutritional Scores in Predicting Delirium in ICU Patients
Provisionally accepted
- 1First Clinical Medical College, Wenzhou Medical University, Wenzhou, China
- 2Nassau University Medical Center, East Meadow, New York, United States
- 3Quzhou City People's Hospital, Quzhou, China
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Background: The nutritional assessment indicators for critically ill patients are diverse, with limited research about comparing the predicting value of different nutritional assessment tools for delirium in the intensive care unit (ICU). Objectives: The study aimed to validate the relationship between malnutrition and ICU delirium and explore the optimal nutritional scores for predicting ICU delirium. Methods: This study was based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and included 319 ICU patients who met the inclusion and exclusion criteria. The study used four nutritional assessment tools: Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), Triglycerides (TG)×Total Cholesterol (TC)×Body Weight (BW) Index (TCBI), and Controlling Nutritional Status (CONUT) score. Restricted cubic spline (RCS) modeling, single-factor logistic regression, and multivariate stepwise logistic regression were employed to elucidate the relationships between each nutritional score and delirium. Using area under the curve (AUC) evaluated the discriminatory ability of the adjusted models. Results: The RCS shows a strong linear connection between delirium and PNI (P for nonlinear = 0.66), as well as between delirium and CONUT score (P for nonlinear = 0.32). Multivariate logistic regression reveals that PNI (OR=2.04, 95% CI: 1.05-4.03, P=0.04) has the closest relationship with ICU delirium. The AUC of the PNI prediction model after adjusting covariates was 0.87 (95% confidence interval: 0.83-0.91, P <0.05). Conclusion: The study confirmed the association between poor nutritional status and increased risk of ICU delirium in patients. PNI demonstrated excellent independent predictive value for ICU delirium, warranting further clinical application and validation.
Keywords: Prognostic nutritional index, Geriatric Nutritional Risk Index, Triglycerides × Total Cholesterol × Body Weight Index, Controlling nutritional status, Delirium
Received: 21 Aug 2024; Accepted: 10 Jul 2025.
Copyright: © 2025 Yu, Chen, Lei, Xu, Zhao and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hongjun Zhao, Quzhou City People's Hospital, Quzhou, 324000, China
Chengshui Chen, Quzhou City People's Hospital, Quzhou, 324000, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.