PhilSPEN Online Journal of Parenteral and Enteral Nutrition

Back to Total Names Codes

(Article 85 | POJ_0079)

Submitted Abstracts

PENSA 2017 Congress

Submitted: August 15, 2017

Abstract ID = 51 | Classification: (2) - Malnutrition and related issues

Title: Inadequate postoperative calorie supplementation in critically ill patients with high modified NUTRIC score is associated with high mortality rate

Author(s): Yun Tae Jung, MD, Seung Hwan Lee, MD, and Jae Gil Lee, MD, PhD

Institution where study was conducted: Department of Surgery, Division of Critical Care and Trauma Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea

Keywords: nutrition, mortality, calorie adequacy, NUTRIC score

Background: Patients at high risk of malnutrition benefit more from nutritional support than those at low risk. In critically ill postoperative patients with mechanical ventilation (MV) support, modified NUTRIC (mNUTRIC) score is useful in nutritional risk assessment.

Objectives: The aim of this study is to identify association of post-operative calorie adequacy with in-hospital mortality and surgical outcomes in patients with high mNUTRIC score.

Methods: We reviewed medical records of 168 patients who required ICU stay with MV support for more than 48 hours after emergency gastro-intestinal surgery for intra-abdominal infection between January 2007 and December 2016. mNUTRIC score and calorie adequacy (5-day calorie intake รท calorie requirement x 100) were calculated for each patient.

Results: Nutritional adequacy was assessed in both high (5-9) and low (0-4) mNUTRIC score groups. Inadequate calorie supplementation, which is defined as calorie adequacy less than 70%, was associated with higher in-hospital mortality (49.1% vs 36.8%; p = 0.021, hazard ratio 2.198 [1.058-4.568]; p = 0.035) than adequate supplementation in high mNUTRIC score group; this was not observed in low mNUTRIC score group. Inadequate calorie supplementation was not associated with anastomosis leakage (18.4% vs 11.8%; p = 0.383), wound complication (35.5% vs 38.2%; p = 0.785), and pulmonary complication (35.5% vs 38.2%; p = 0.902).

Conclusion: Inadequate calorie supplementation after GI surgery is associated with higher in-hospital mortality in patients with high mNUTRIC score. Adequate supplement of calorie for critically ill post-operative patients with high nutritional risk could contribute to improvement in their in-hospital mortality.