Verghese Prashant P, Mathai Ashu Sara, Abraham Valsamma, Kaur Paramdeep
Department of Anaesthesiology and Critical Care, Christian Medical College and Hospital, Ludhiana, Punjab, India.
Department of Anaesthesiology and Critical Care, Believers Church Medical College and Hospital, Thiruvalla, Kerala, India.
Indian J Anaesth. 2018 Jan;62(1):29-35. doi: 10.4103/ija.IJA_513_17.
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.
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 test, Chi-square test, Fisher's exact test and multivariate logistic regression analysis.
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, = 0.001) and 11.11 (95% CI-2.26-54.66, = 0.003), respectively.
Malnutrition is commonly present at admission among medical ICU patients, and is associated with higher ICU mortality.
早期识别住院患者的营养不良状况对于制定恰当的个体化营养策略至关重要。本研究旨在评估成年重症监护病房（ICU）收治的内科患者入院时的营养状况，并确定妨碍他们实现每日喂养目标的因素。
这是一项针对200名成年内科ICU患者的为期1年的前瞻性观察性研究。该研究基于每日记录开展。主要结局是成年ICU收治的内科患者入院时的营养状况。所采用的统计分析检验包括独立样本t检验、卡方检验、Fisher精确检验和多因素逻辑回归分析。
在我们研究的200例患者中，分别有45%、48.5%和9%的患者存在轻度、中度和重度营养不良，分别对应主观全面评定（SGA）的A、B和C级。未实现每日喂养目标的最常见原因是喂养物资采购延迟（17.57%）以及因进行操作而暂停喂养（16.36%）。ICU住院时间的总体均值为8.63±7.26天，ICU死亡率为47.5%（95/200）。入院时SGA评定为B级和C级的患者在ICU的死亡风险更高，校正后的优势比分别为3.54（95%置信区间[CI] - 1.71 - 7.33，P = 0.001）和11.11（95% CI - 2.26 - 54.66，P = 0.003）。
内科ICU患者入院时普遍存在营养不良，且与ICU死亡率较高相关。
