Assessment of malnutrition and enteral feeding practices in the critically ill: A single-centre observational study

• Published in: Indian journal of anaesthesia Vol. 62; no. 1; pp. 29 - 35
• Main Authors: Verghese, Prashant, Mathai, Ashu, Abraham, Valsamma, Kaur, Paramdeep
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.01.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Anesthesiology; Care and treatment; Chi-square tests; Critical care; Critically ill persons; Enteral nutrition; Health aspects; Hospitals; Intensive care; intensive care unit; Intensive care units; Malnutrition; Mortality; Nutrition; Observational studies; Original; Parenteral nutrition; Patients; Primary care; subjective global assessment; Ventilators; malnutrition; intensive care unit; subjective global assessment; Enteral nutrition
• ISSN: 0019-5049; 0976-2817
• DOI: 10.4103/ija.IJA_513_17

Background and Aims: Early identification of malnutrition among hospitalised patients is essential to institute appropriate patient-specific nutritional strategies. This study was conducted to evaluate the nutritional status of medical patients at admission to the adult intensive care unit (ICU) and to identify factors which prevent attainment of daily feeding goals in them. Methods: This was a 1 year prospective, observational study on 200 medical adult ICU patients. The study was carried out based on daily documentation. The primary outcome was the nutritional status of medical Patients at admission to the adult ICU. The tests for statistical analysis used were independent t test, Chi-square test, Fisher's exact test and multivariate logistic regression analysis. Results: Out of the 200 patients in our study, 45%, 48.5% and 9% of patients had mild, moderate and severe malnutrition, respectively, corresponding to subjective global assessment (SGA) rating A,B and C, respectively. The most common reasons for non-attainment of daily feeding goals were delayed feed procurement (17.57%), and feeds being held for procedures (16.36%). The overall mean length of ICU stay was 8.63 ± 7.26 days, and the ICU mortality rate was 47.5% (95/200). Patients with SGA rating B and C at admission had higher risk of mortality in the ICU, with an adjusted odds ratio of 3.54 (95% confidence interval [CI]- 1.71-7.33, P = 0.001) and 11.11 (95% CI-2.26-54.66, P = 0.003), respectively. Conclusion: Malnutrition is commonly present at admission among medical ICU patients, and is associated with higher ICU mortality.