Kim Min Kyoon, Choi Yoo Shin, Suh Suk Won, Lee Seung Eun, Park Yong Gum, Kang Hyun
Department of Surgery, College of Medicine, Chung-Ang University, Seoul 06973, Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul 06973, Korea.
Clin Nutr Res. 2021 Apr 19;10(2):107-114. doi: 10.7762/cnr.2021.10.2.107. eCollection 2021 Apr.
Adequate nutritional support in critically ill patients is important, however, sometimes it has been neglected in perioperative period of patients at surgical intensive care units (SICU). The aim of this study was to investigate whether approaching target calorie intake of surgical patients influences on their clinical outcomes. A total of 279 patients who admitted at SICU in perioperative period from August 2014 to July 2016 at our hospital were analyzed. Demographics, supplied calorie amount and its method, lengths of SICU and hospital stay, and mortality of study population were collected. Among 279 patients, 103 patietns (36.9%) approached target calorie intake during SICU stay. Patients who approached target calorie intake had significantly decreased length of stay in SICU (10.78 ± 11.5 vs. 15.3 ± 9.9, p = 0.001) and hospital (54.52 ± 40.6 vs. 77.72±62.2, p < 0.001), than those did not, however there was no significant difference of mortality (9.7% vs. 8.5%, p = 0.829). Enteral feeding was a significant factor for target calorie achievement (odd ratio [OR], 2.029; 95% confidence interval [CI], 1.096-3.758; p = 0.024) and especially in patients with ≤ 7 days of SICU stay (OR, 4.13; 95% CI, 1.505-11.328; p = 0.006). Target calorie achievement in surgical patients improves clinical outcomes and enteral feeding, especially in early postoperative period would be an effective route of nutrition.
在重症患者中提供充足的营养支持很重要,然而,在外科重症监护病房(SICU)患者的围手术期,营养支持有时会被忽视。本研究的目的是调查达到外科患者目标热量摄入是否会影响其临床结局。对2014年8月至2016年7月在我院围手术期入住SICU的279例患者进行了分析。收集了研究人群的人口统计学资料、提供的热量及其方式、SICU住院时间和住院时间以及死亡率。在279例患者中,103例患者(36.9%)在SICU住院期间达到了目标热量摄入。达到目标热量摄入的患者在SICU的住院时间(10.78±11.5天对15.3±9.9天,p=0.001)和住院时间(54.52±40.6天对77.72±62.2天,p<0.001)显著短于未达到目标热量摄入的患者,然而死亡率没有显著差异(9.7%对8.5%,p=0.829)。肠内喂养是实现目标热量的一个重要因素(比值比[OR],2.029;95%置信区间[CI],1.096-3.758;p=0.024),尤其是在SICU住院时间≤7天的患者中(OR,4.13;95%CI,1.505-11.328;p=0.006)。外科患者实现目标热量摄入可改善临床结局,肠内喂养,尤其是在术后早期,将是一种有效的营养途径。