When timing and dose of nutrition support were examined, the modified Nutrition Risk in Critically Ill (mNUTRIC) score did not differentiate high-risk patients who would derive the most benefit from nutrition support: a prospective cohort study

Annals of Intensive Care

Robert J. L. Fraser¹  Ai Ping Chua²  Gabriel Jun Yung Wong³  Ka Po Cheung³  Michelle Miller⁴  Charles Chin Han Lew⁴  Mary Foong Fong Chong⁵ 

[1] Department of Gastroenterology and Hepatology, College of Medicine and Public Health, Flinders University;Department of Respiratory Medicine, Ng Teng Fong General Hospital;Dietetics and Nutrition Department, Ng Teng Fong General Hospital;Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University;Saw Swee Hock School of Public Health, National University of Singapore;

关键词: NUTRIC;    Mortality;    Nutrition support;    Critical illness;   

DOI  :  10.1186/s13613-018-0443-1

来源: DOAJ

【 摘 要 】

Abstract Background The timing and dose of exclusive nutrition support (ENS) have not been investigated in previous studies aimed at validating the modified Nutrition Risk in Critically Ill (mNUTRIC) score. We therefore evaluated the mNUTRIC score by determining the association between dose of nutrition support and 28-day mortality in high-risk patients who received short- and longer-term ENS (≤ 6 days vs. ≥ 7 days). Methods A prospective cohort study included data from 252 adult patients with > 48 h of mechanical ventilation in a tertiary care institution in Singapore. The dose of nutrition support (amount received ÷ goal: expressed in percentage) was calculated for a maximum of 14 days. Associations between the dose of energy (and protein) intake and 28-day mortality were evaluated with multivariable Cox regressions. Since patients have different durations of ENS, only the first 6 days of ENS in patients with short- and longer-term ENS were assessed in the Cox regressions to ensure a valid comparison of the associations between energy (and protein) intake and 28-day mortality. Results In high-risk patients with short-term ENS (n = 106), each 10% increase in goal energy intake was associated with an increased hazard of 28-day mortality [adj-HR 1.37 (95% CI 1.17, 1.61)], and this was also observed for protein intake [adj-HR 1.31 (95% CI 1.10, 1.56)]. In contrast, each 10% increase in goal protein intake in high-risk patients with longer-term ENS (n = 146) was associated with a lower hazard of 28-day mortality [adj-HR 0.78 (95% CI 0.66, 0.93)]. The mean mNUTRIC scores in these two groups of patients were similar. Conclusion When timing and dose of nutrition support were examined, the mNUTRIC did not differentiate high-risk patients who would derive the most benefit from nutrition support.

【 授权许可】

Unknown