Dijkink Suzan, Meier Karien, Krijnen Pieta, Yeh D Dante, Velmahos George C, Arbous M Sesmu, Salim Ali, Hoogendoorn Jochem M, Schipper Inger B
Department of Surgery, Leiden University Medical Center, The Netherlands.
Contributed equally to this manuscript and therefore share first authorship.
Nutr Health. 2019 Dec;25(4):291-301. doi: 10.1177/0260106019868884. Epub 2019 Aug 28.
Polytrauma patients are at risk of considerable harm from malnutrition due to the metabolic response to trauma. However, there is little knowledge of (the risk of) malnutrition and its consequences in these patients. Recognition of sub-optimally nourished polytrauma patients and their nutritional needs is crucial to prevent complications and optimize their clinical outcomes.
The primary objective is to investigate whether polytrauma patients admitted to the Intensive Care Unit (ICU) who have or develop malnutrition have a higher complication rate than patients who are and remain well nourished. Secondary objectives are to determine the prevalence of pre-existent and in-hospital acquired malnutrition in these patients, to assess the association between malnutrition and long-term outcomes, and to determine the association between serum biomarkers (albumin and pre-albumin) and malnutrition.
This international observational prospective cohort study will be performed at three Level-1 trauma centers in the United States and two Level-1 centers in the Netherlands. Adult polytrauma patients (Injury Severity Score ≥16) admitted to the ICU of one of the participating centers directly from the Emergency Department are eligible for inclusion. Nutritional status and risk of malnutrition will be assessed using the Subjective Global Assessment (SGA) scale and Nutritional Risk in Critically Ill (NUTRIC) score, respectively. Nutritional intake, biomarkers and complications will be collected daily. Patients will be followed up to one year after discharge for long-term outcomes.
This international prospective cohort study aims to gain more insight into the effect and consequences of malnutrition in polytrauma patients admitted to the ICU.
由于创伤后的代谢反应，多发伤患者面临因营养不良而遭受严重伤害的风险。然而，对于这些患者营养不良（的风险）及其后果知之甚少。识别营养状况未达最佳的多发伤患者及其营养需求对于预防并发症和优化临床结局至关重要。
主要目标是调查入住重症监护病房（ICU）的多发伤患者中，已存在或发生营养不良的患者是否比营养状况良好且保持良好的患者并发症发生率更高。次要目标是确定这些患者中既往存在的和住院期间获得性营养不良的患病率，评估营养不良与长期结局之间的关联，并确定血清生物标志物（白蛋白和前白蛋白）与营养不良之间的关联。
这项国际观察性前瞻性队列研究将在美国的三个一级创伤中心和荷兰的两个一级中心进行。直接从急诊科入住参与中心之一的ICU的成年多发伤患者（损伤严重度评分≥16）符合纳入条件。将分别使用主观全面评定（SGA）量表和危重症患者营养风险（NUTRIC）评分评估营养状况和营养不良风险。每天收集营养摄入、生物标志物和并发症情况。患者出院后将随访一年以了解长期结局。
这项国际前瞻性队列研究旨在更深入了解入住ICU的多发伤患者营养不良的影响和后果。
