Modified NUTRIC score and clinical outcomes in critically ill medical patients: A prospective cohort study in Bosnia and Herzegovina.

Malnutrition and nutritional risk are prevalent among critically ill patients. However, research from medical intensive care units (ICUs) in Bosnia and Herzegovina and the Western Balkans is scarce. This study sought to compare clinical characteristics, laboratory results, and hospital outcomes in critically ill medical patients, differentiating between those with low and high modified Nutrition Risk in the Critically Ill (mNUTRIC) scores. This prospective, single-center observational cohort study enrolled 102 adult patients admitted to a tertiary medical ICU from July 2025 to January 2026. The mNUTRIC score was evaluated within 48 hours of ICU admission, categorizing patients into low-score (0-4) and high-score (5-9) groups. A high mNUTRIC score was observed in 67 patients (65.7%). Compared to the low-score group, these patients exhibited greater illness severity, more comorbidities, less favorable laboratory findings, longer ICU stays (median: 11 vs. 7 days; p = 0.019), and extended durations of mechanical ventilation (median: 6 vs. 4 days; p = 0.037). No significant differences were found between the groups for overall hospital mortality (56.7% vs. 42.9%; p = 0.183) or ICU mortality (22.4% vs. 28.6%; p = 0.491). Among ICU survivors, post-ICU mortality was higher in the high-score group (44.2% vs. 20.0%; p = 0.038), though this observation was drawn from a specific subgroup. In this exploratory cohort, a high mNUTRIC score identified patients with increased clinical severity, longer ICU admissions, and prolonged mechanical ventilation. However, it did not independently predict mortality. The study could not ascertain the impact of mNUTRIC-guided nutritional interventions due to the lack of assessment of nutritional intake and interventions.