PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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(Article 118 | POJ_0112)

Submitted Abstracts

PENSA 2017 Congress

Submitted: October 6, 2017

Abstract ID = 82 | Classification: (3) - Critical care and related issues

Title: Is NUTRIC Score vital to implement aggressive nutrition support in critically ill?

Author(s): Daphnee.D.K,Rajalakshmi.P Zahira Khathun.A,B Shankar

Institution where study was conducted: Department of Dietetics, Apollo Hospitals, Greams Road, Chennai, India

Keywords: Critically Ill, Aggressive Nutrition Therapy, NUTRIC score

Background: Identifying and addressing patients at nutritional risk is a core competency of Clinical Dietitians

Objectives: Hence, this study aimed to identify patients at nutritional risk and implement aggressive nutrition support in critically ill and its impact on outcomes.

Methods: A prospective study was conducted in multidisciplinary critical care unit (CCU) of tertiary care hospital (Feb to April 2016). All patients who were admitted into CCU and on enteral nutrition for ≥3days were included. Patients’ demographics, NUTRIC Score, Subjective Global Assessment (SGA) and outcomes were recorded. Data was analysed using SPSS version 20.0.

Results: Out of 158 patients with mean age of 60.15±16.3, 74 met the inclusion criteria. As per NUTRIC score, 47% required aggressive nutrition support and 62% were malnourished based on SGA. Achieving ≥80% of mean calorie and protein were comparable between NUTRIC<5 and >5, (p=0.153; p=0.228). Aggressive nutrition support (≥80%) within 72 hours is vital even for low risk (NUTRIC<5), as it impacts the mortality in critically ill (p ≤ 0.005), though a statistical significance was not noted for high risk (NUTRIC≥5). Attaining ≥80% (mean calories) in high risk group decreased the days of ventilation (p=0.050) and hospital stay (p=0.027). Providing ≥80% of average calories in malnourished patients as per SGA improved the discharge rate significantly (p=0.022).

Conclusion: Aggressive nutrition support to achieve nutritional targets within 72 hours is crucial for all critically ill. Since the NUTRIC score is time consuming and laborious to identify patients at risk, a simple bedside tool like SGA is recommended.