Nutritional Risk Index (NRI)

Why Use

Malnutrition is a strong predictor of morbidity and mortality, including major operative complications. Identifying patients at risk of malnutrition may potentially allow for timely interventions, such as dietary support, to improve outcomes.

When to Use

Use as a screening tool for malnutrition, including hospitalized patients and those undergoing surgery, chemotherapy, or other treatments where malnutrition may impact outcomes. May be helpful as part of a routine evaluation in older adults or chronically ill patients.

Formula

Pearls / Pitfalls

Lower scores strongly correlated with postoperative complications, mortality, and length of hospital stay. Relies on albumin in its assessment, which may reduce accuracy in patients with hypoalbuminemia due to non-nutritional factors (e.g., liver disease). Does not evaluate micronutrient deficiencies or assess dietary intake in detail. Intended as a screening tool, not as a diagnostic tool.

Management

If nutritional risk is identified: Optimize nutrition, which may include: Consultation with a dietitian. Encouraging nutrient-dense foods. Oral supplementation (e.g., protein shakes, caloric boosters). Enteral feedings, if oral intake is not feasible or inadequate. Parenteral nutrition, only if enteral feeding is contraindicated or insufficient. Monitor and reassess nutritional status regularly. If no risk: Continue routine monitoring in at-risk populations. Address any modifiable factors contributing to potential future malnutrition.

Advice

The results of this tool should be used in conjunction with clinical judgment and specialist recommendations to guide management.

More Information

Interpretation: NRI Score Risk of malnutrition >100.0 No risk 97.6-100.0 Mild 83.5-97.5 Moderate <83.5 Severe From Prasad 2016 .