Department of Critical Care, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK.
Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, UK.
Eur J Clin Nutr. 2018 Jul;72(7):986-992. doi: 10.1038/s41430-018-0181-3. Epub 2018 May 17.
BACKGROUND/OBJECTIVES: Reduced appetite is a recognised physiological symptom in survivors of critical illness. While reduced appetite has been reported by patients after intensive care unit (ICU) discharge, quantification using visual analogue scales (VAS) has not been previously performed, and follow-up duration has been limited. We aimed to describe appetite scores in ICU survivors during the first 3 months after ICU discharge and explore association with systemic inflammation.
SUBJECTS/METHODS: Secondary analysis of data collected in a complex rehabilitation intervention trial (RECOVER). A subgroup of 193 patients provided specific consent for inclusion in the blood sampling sub-study during consent for the main study. We studied appetite using a VAS; serum C-reactive protein (CRP); interleukin-1β and interleukin-6 (IL-1β and IL-6); and hand-grip strength.
Median (interquartile range) score on 0-10 appetite VAS was 4.3 (2.0-6.5) 1 week after ICU discharge, improving to 7.1 (4.6-8.9) by 3 months (mean difference 1.7 (0.9-2.4), p < 0.01). Number of days spent in an acute hospital following an intensive care stay was associated with poorer appetite scores (p = 0.03). CRP concentration and appetite were significantly associated at 1 week after ICU discharge (p = 0.01), but not at 3 months after ICU discharge (p = 0.67).
ICU survivors experience reduced appetite during the acute recovery phase of critical illness that could impact on nutritional recovery and this was associated with CRP concentration 1 week after ICU discharge.
背景/目的：减少食欲是危重病幸存者公认的生理症状。虽然有报道称重症监护病房（ICU）出院后的患者存在食欲下降，但尚未使用视觉模拟评分（VAS）进行量化，且随访时间有限。我们旨在描述 ICU 幸存者在 ICU 出院后 3 个月内的食欲评分，并探讨其与全身炎症的关系。
研究对象/方法：对一项复杂康复干预试验（RECOVER）中收集的数据进行二次分析。在主要研究获得同意的基础上，有 193 名患者提供了具体的同意，纳入血液采样子研究。我们使用 VAS 评估食欲；血清 C 反应蛋白（CRP）；白细胞介素-1β和白细胞介素-6（IL-1β和 IL-6）；以及握力。
ICU 出院后 1 周，0-10 食欲 VAS 的中位数（四分位距）评分为 4.3（2.0-6.5），3 个月时改善至 7.1（4.6-8.9）（平均差异 1.7（0.9-2.4），p < 0.01）。重症监护病房后在急性医院住院的天数与食欲评分较差相关（p = 0.03）。CRP 浓度和食欲在 ICU 出院后 1 周时显著相关（p = 0.01），但在 ICU 出院后 3 个月时不相关（p = 0.67）。
危重病幸存者在急性恢复期会出现食欲减退，这可能会影响营养恢复，并且这与 ICU 出院后 1 周时的 CRP 浓度有关。
