<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092017000300140</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Desarrollo de la escala modificada simplificada de riesgo nutricional (NUTRIC) en el paciente crítico]]></article-title>
<article-title xml:lang="en"><![CDATA[Development of a modified, simplified nutritional risk score (NUTRIC) in critically ill patients]]></article-title>
<article-title xml:lang="pt"><![CDATA[Desenvolvimento da escala modificada simplificada de risco nutricional (nutric) no paciente em estado crítico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz Gómez]]></surname>
<given-names><![CDATA[Lida Montserrat]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Galindo Martín]]></surname>
<given-names><![CDATA[Carlos Alfredo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monares Zepeda]]></surname>
<given-names><![CDATA[Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez Galavis]]></surname>
<given-names><![CDATA[Brenda Silvana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aportela Vázquez]]></surname>
<given-names><![CDATA[Verónica Angélica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez Guillén]]></surname>
<given-names><![CDATA[Job Heriberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Nava]]></surname>
<given-names><![CDATA[Víctor Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital San Ángel Inn Universidad/ITESM  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<volume>31</volume>
<numero>3</numero>
<fpage>140</fpage>
<lpage>144</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092017000300140&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092017000300140&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092017000300140&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La escala NUTRIC es una de las herramientas propuestas para la evaluación del riesgo nutricional en pacientes críticamente enfermos. Contiene dos índices pronósticos de gravedad: Acute Physiology and Chronic Evaluation II (APACHE II) y la puntuación Sequential Organ Failure Assessment (SOFA), lo que genera un alto riesgo de colinealidad.  Métodos:  En el presente estudio se pretende eliminar la colinealidad otorgada por el APACHE II y la puntuación SOFA utilizados en la puntuación NUTRIC, simplificando dicha herramienta. Se realizaron dos escalas alternas: NUTRIC modificado con un ajuste por APACHE II, eliminando el puntaje por APACHE II y obteniendo un coeficiente de ajuste mediante regresión lineal, y NUTRIC sin APACHE II, restando los puntos otorgados por éste. Posteriormente, se hicieron curvas ROC con el fin de determinar el desempeño de ambas escalas en detectar riesgo nutricional.  Resultados:  Fueron incluidos 225 pacientes a lo largo del estudio. La regresión lineal en contra del NUTRIC convencional mostró para el NUTRIC sin APACHE II un coeficiente de Pearson = 0.918, r2 = 0.843, p &lt; 0.05, m = 1.368, b = 0, y para el NUTRIC modificado un coeficiente de Pearson = 0.918, r2 = 0.843, p &lt; 0.05. Ambas curvas ROC resultaron con un área bajo la curva de 0.95, p &lt; 0.05.  Conclusión:  Al eliminar el APACHE II de la escala NUTRIC se evita la colinealidad, con lo que se obtienen dos puntos corte de tres y cinco para la detección de bajo riesgo (sensibilidad = 99%) y alto riesgo (especificidad = 99%), respectivamente, y un puntaje de cuatro para realizar una evaluación especializada.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  The NUTRIC score is one of the tools proposed for nutritional risk assessment in critically ill patients. This score uses two severity scores: Acute Physiology and Chronic Evaluation II (APACHE II) and Sequential Organ Failure Assessment score (SOFA), which generates a high risk for collinearity.  Methods:  The goal of the present study is to eliminate the collinearity between the APACHE II and the SOFA used in the NUTRIC score, optimizing such tool. Two alternative scales were developed: modified NUTRIC with an adjustment for APACHE II, by eliminating the points given by the APACHE II and obtaining an adjustment coefficient through linear regression, and the NUTRIC without APACHE II. ROC curves were built to determine the performance of both scores for detecting nutritional risk.  Results:  Two hundred twenty five patients where included in the study. Linear regression between the conventional NUTRIC score and the NUTRIC without APACHE II showed a Pearson coefficient of 0.918, r(2) = 0.843, p &lt; 0.05, m = 1.368, b = 0, and the modified NUTRIC, a Pearson coefficient of 0.918, r(2) = 0.843, p &lt; 0.05. Both ROC curves resulted in equal areas under the curve of 0.951, p &lt; 0.05.  Conclusion:  By eliminating the APACHE II of the NUTRIC score, collinearity is avoided, obtaining two cutoff points of 3 and 5 to detect low risk (sensibility = 99%) and high risk (specificity = 99%), respectively, and a score of 4 to perform an advanced assessment, optimizing its time.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  O escore NUTRIC é uma das ferramentas propostas para a avaliação do risco nutricional em pacientes em estado crítico. Esta escala contém dois índices de prognóstico de gravidade: Acute Physiology and Chronic Evaluation II (APACHE II) e Sequential Organ Failure Assessment score (SOFA), gerando um elevado risco de colinearidade.  Métodos:  Neste estudo pretendemos eliminar a colinearidade outorgada pelo APACHE II e SOFA escore utilizados no NUTRIC escore, simplificando essa ferramenta. Realizaram-se duas escalas alternativas: NUTRIC modificado com um ajuste pelo APACHE II, eliminando a pontuação por APACHE II e obtendo um coeficiente de ajuste por regressão linear e NUTRIC sem APACHE II, subtraindo os pontos atribuídos pelo APACHE II. Posteriormente realizaram-se curvas ROC com o fim de determinar o desempenho de ambas escalas em detectar o risco nutricional.  Resultados:  225 pacientes foram incluídos ao longo do estudo. A regressão linear em contra da NUTRIC convencional mostrou para NUTRIC sem APACHE II um coeficiente de Pearson = 0.918, r 2 = 0.843, p &lt; 0.05, m = 1.368, b = 0 e para NUTRIC modificado um coeficiente de Pearson = 0.918, um r 2 = 0.843, p &lt; 0.05. Ambas curvas ROC resultaram com uma área sob a curva de 0.95, p &lt; 0.05.  Conclusão:  Ao eliminar o APACHE II da escala NUTRIC evitamos a colinearidade obtendo dois pontos de corte de 3 e 5 para a detecção de baixo risco (sensibilidade = 99%) e de alto risco (especificidade = 99%), respectivamente, e uma pontuação de 4 para uma avaliação especializada.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Nutricional]]></kwd>
<kwd lng="es"><![CDATA[críticamente enfermo]]></kwd>
<kwd lng="es"><![CDATA[puntuación NUTRIC]]></kwd>
<kwd lng="es"><![CDATA[evaluación]]></kwd>
<kwd lng="en"><![CDATA[Nutritional]]></kwd>
<kwd lng="en"><![CDATA[critically ill]]></kwd>
<kwd lng="en"><![CDATA[NUTRIC score]]></kwd>
<kwd lng="en"><![CDATA[assessment]]></kwd>
<kwd lng="pt"><![CDATA[Nutricional]]></kwd>
<kwd lng="pt"><![CDATA[paciente em estado crítico]]></kwd>
<kwd lng="pt"><![CDATA[escore NUTRIC]]></kwd>
<kwd lng="pt"><![CDATA[avaliação]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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