ICU, Sepsis & Critical Care

NUTRIC Score Calculator – ICU Nutrition Risk Assessment

Clinical calculation support · Verify results before clinical use

Modified NUTRIC (mNUTRIC) Score

Enter the patient's clinical data at or near ICU admission. All five variables are required.

—mNUTRIC

Patient and severity variables

Age

Patient age in completed years.

0–2 points

Age (years) Scoring: <50 = 0; 50–74 = 1; ≥75 = 2.

APACHE II Score

Use the APACHE II score calculated for the relevant admission assessment.

0–3 points

APACHE II (points) Scoring: <15 = 0; 15–19 = 1; 20–27 = 2; ≥28 = 3.

SOFA Score

Sequential Organ Failure Assessment score.

0–2 points

SOFA (points) Scoring: <6 = 0; 6–9 = 1; ≥10 = 2.

Number of Comorbidities

Count documented pre-existing comorbid conditions.

0–1 point

Comorbidities (number) Scoring: 0–1 = 0; ≥2 = 1. Count conditions according to the source study's comorbidity definition and local documentation.

Hospital Stay Before ICU Admission

Elapsed time from hospital admission to ICU admission.

0–1 point

Pre-ICU hospital stay (days) Scoring: <1 day = 0; ≥1 day = 1. Enter 0 for direct admission to ICU from outside the hospital.

—of 9 points

Nutritional risk category

—

Score breakdown

Component	Points
Total mNUTRIC score	—

About the mNUTRIC Score

The modified Nutrition Risk in the Critically ill (mNUTRIC) score is an ICU-specific risk assessment tool developed to identify critically ill patients in whom nutrition risk is associated with adverse clinical outcomes. It uses five variables reflecting age, illness severity, comorbidity burden, and time spent in hospital before ICU admission.

The modified version omits interleukin-6 (IL-6) from the original NUTRIC score. The mNUTRIC total ranges from 0 to 9.

Variables and Points

Variable	Value	Points
Age (years)	<50 / 50–74 / ≥75	0 / 1 / 2
APACHE II	<15 / 15–19 / 20–27 / ≥28	0 / 1 / 2 / 3
SOFA	<6 / 6–9 / ≥10	0 / 1 / 2
Comorbidities	0–1 / ≥2	0 / 1
Hospital-to-ICU days	<1 / ≥1	0 / 1

Interpretation

mNUTRIC score	Category
0–4	Low nutritional risk
5–9	High nutritional risk

Clinical use

A high score is associated with worse outcomes in critically ill populations; it is not a diagnosis of malnutrition.
Use the score alongside a comprehensive nutrition assessment, clinical examination, history of weight and intake changes, and evaluation of muscle mass where feasible.
The score does not independently prescribe calorie/protein targets or determine the route or timing of nutrition support.

References

Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Critical Care. 2011;15:R268. DOI: 10.1186/cc10546.

Mendes R, Policarpo S, Fortuna P, et al.; Portuguese NUTRIC Study Group. Nutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients—a multicenter prospective cohort study. Journal of Critical Care. 2017;37:45–49. DOI: 10.1016/j.jcrc.2016.08.001.

Singer P, Reintam Blaser A, Berger MM, et al. ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit. Clinical Nutrition. 2023;42(9):1671–1689. DOI: 10.1016/j.clnu.2023.07.011.

Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition. 2019;38(1):48–79. DOI: 10.1016/j.clnu.2018.08.037. This foundational guideline discussed limitations in validation of ICU nutrition risk scores.

Clinical disclaimer: The mNUTRIC score is a risk stratification instrument, not a stand-alone diagnostic test for malnutrition and not a substitute for individualized clinical assessment. ESPEN guidance emphasizes general clinical assessment of nutritional status in critically ill patients and consideration of medical nutrition therapy, particularly when ICU stay exceeds 48 hours. The 2019 ESPEN guideline also highlighted limitations in the validation of ICU-specific nutrition scores; therefore, do not use mNUTRIC as a stand-alone determinant of nutritional diagnosis or treatment. Interpret this score in the context of the patient's overall condition, local protocols, and current nutrition guidelines.