Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool
TLDR
This scoring algorithm may be helpful in identifying critically ill patients most likely to benefit from aggressive nutrition therapy in the intensive care unit (ICU), and based on the statistical significance in the multivariable model, the final score used all candidate variables except BMI.Abstract:
To develop a scoring method for quantifying nutrition risk in the intensive care unit (ICU). A prospective, observational study of patients expected to stay > 24 hours. We collected data for key variables considered for inclusion in the score which included: age, baseline APACHE II, baseline SOFA score, number of comorbidities, days from hospital admission to ICU admission, Body Mass Index (BMI) < 20, estimated % oral intake in the week prior, weight loss in the last 3 months and serum interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) levels. Approximate quintiles of each variable were assigned points based on the strength of their association with 28 day mortality. A total of 597 patients were enrolled in this study. Based on the statistical significance in the multivariable model, the final score used all candidate variables except BMI, CRP, PCT, estimated percentage oral intake and weight loss. As the score increased, so did mortality rate and duration of mechanical ventilation. Logistic regression demonstrated that nutritional adequacy modifies the association between the score and 28 day mortality (p = 0.01). This scoring algorithm may be helpful in identifying critically ill patients most likely to benefit from aggressive nutrition therapy.read more
Citations
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Journal ArticleDOI
Assessment of malnutrition and enteral feeding practices in the critically ill: A single-centre observational study
TL;DR: Malnutrition is commonly present at admission among medical ICU patients, and is associated with higher ICU mortality, as well as factors which prevent attainment of daily feeding goals in them.
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Higher BMI is associated with reduced mortality but longer hospital stays following ICU discharge in critically ill Asian patients.
Amartya Mukhopadhyay,Yanika Kowitlawakul,Jeyakumar Henry,Venetia Ong,Claudia Leong,Bee Choo Tai +5 more
TL;DR: In multiethnic critically ill Asian patients, the prevalence of overweight/obesity was high and although higher BMI was associated with reduced risk of 28-day mortality, obese patients stayed significantly longer in the hospital following ICU discharge.
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Nutritional adequacy in critically ill patients: Result of PNSI study.
Zeinab Javid,Mahdi Shadnoush,Majid Khadem-Rezaiyan,Niyaz Mohammadzadeh Honarvar,Alireza Sedaghat,Seyed Mohammadreza Hashemian,Seyed Hossein Ardehali,Mohsen Nematy,Omid Pournik,Mohammad Taghi Beigmohammadi,Mohammad Safarian,Omid Moradi Moghaddam,Masoum Khoshfetrat,Farid Zand,Afshin Mohammad Alizadeh,Mahboube Kosari Monfared,Fatemeh Mazaheri Eftekhar,Maryam Mohamadi Narab,Arefe Sadat Taheri,Khatereh Babakhani,Behnam Foroutan,Tannaz Jamialahmadi,Bahareh Jabbarzadeh Gangeh,Mehrnoush Meshkani,Fahime Kimiaee,Abdolreza Norouzy +25 more
TL;DR: In this paper, a cross-sectional study assessed 50 ICU's patients out of 25 hospitals in the 10 major regions of Iran's health system and was performed using the multistage cluster sampling design.
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Nutritional risk assessment at admission can predict subsequent muscle loss in critically ill patients
Amartya Mukhopadhyay,Bee Choo Tai,Deepa Remani,Jeya Henry,Yanika Kowitlawakul,Zudin Puthucheary,Zudin Puthucheary +6 more
TL;DR: In this paper, the authors studied the association between modified NUTrition RIsk in the Critically ill (mNUTRIC) score obtained at admission to intensive care unit (ICU) and subsequent muscle loss.
Journal ArticleDOI
Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: review and rationale for the EFFORTcombo trial.
Aileen Hill,Daren K. Heyland,Gunnar Elke,Stefan J. Schaller,Reto Stocker,Christoph Haberthür,Christian von Loeffelholz,Ulrich Suchner,Zudin Puthucheary,Danielle E. Bear,Julia Ney,Kai C. Clasen,Patrick Meybohm,Simone Lindau,Thea Laurentius,Christian Stoppe +15 more
TL;DR: If an early combination of EN and high-protein PN (EN+PN) is effective in reaching energy and protein goals in patients at high nutritional risk, while avoiding overfeeding is tested in the here-presented EFFORTcombo trial.
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