Nutritional Risk Assessment and Its Prognostic Impact in Critically Ill Patients with Neurological Diseases

The research aims to apply and evaluate a standardized protocol for nutritional risk assessment and nutritional support management, and to assess its predictive value in individuals with severe neurological disorders who are at risk of malnutrition. A retrospective analysis was performed on 930 suitable patients hospitalized in the Neurology Intensive Care Unit (NICU) at Xuanwu Hospital, Capital Medical University, between January 2012 and December 2019. At discharge, patients were categorized based on modified Rankin Scale (mRS) results (excellent prognosis: mRS 0-2, n = 600; bad prognosis: mRS 3-6, n = 330) and survival status (survivor: n = 869; deceased: n = 61). The protocol included baseline characteristics and biochemical evaluations, admission Nutritional Risk Screening 2002 (NRS 2002) scores, identifying the nutritional support modality, estimation of typical energy intake throughout the first 7 days, and level of disease evaluation using standardized assessment instruments such as the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), and National Institutes of Health Stroke Scale (NIHSS). Univariate studies, multivariate logistic regression estimation, and receiver operating characteristic (ROC) curve assessment were used to assess predictive significance. The standardized protocol enabled the systematic identification of nutritional risk, stratification of clinical severity, and early guidance for planning nutritional interventions. Key risk indicators, including elevated NRS 2002, APACHE II, and NIHSS scores, advanced age, and inadequate early energy intake, were associated with unfavorable outcomes. In contrast, higher GCS and adequate vitamin B12 levels demonstrated protective tendencies. ROC analysis confirmed that NRS 2002 provided the most effective predictive utility for both functional outcome and survival status. The findings demonstrate that structured nutritional risk assessment and standardized support implementation offer practical value for early prognostic judgment and Nutritional decision-making for severely ill individuals suffering from neurological diseases.