Abate Semagn Mekonnen, Abafita Bedru Jemal, Barega Muhiddin Tadesse, Estifanos Mahlet Berhanu, Nega Solomon, Mantefardo Bahru, Meno Abinet
Department of Anesthesia, College of Medicine and Health Science, Wollo University, P. O. BOX: 419, Dilla, Ethiopia.
Department of Anesthesia, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
BMC Nutr. 2024 Nov 28;10(1):154. doi: 10.1186/s40795-024-00964-5.
Malnutrition is a major public health issue, causing significant mortality and morbidity, especially in developing nations. However, the magnitude and its impact on clinical outcomes in Intensive Care Unit (ICU) patients need to be investigated better in Sub-Saharan Africa, and this study was intended to address these issues.
The objective of this study was to assess the effect of malnutrition on clinical outcomes among ICU patients.
A prospective cohort study was conducted among 436 ICU patients, 218 of whom were malnourished. After obtaining ethical approval, malnourished and well-nourished patients were followed for thirty days to examine the effects of nutritional status on clinical outcomes and its determinants. At admission, nutritional screening and evaluation were performed with Subjective Global Assessment (SGA) and Malnutrition Universal Screening Tool (MUST), and during the next thirty days, it was evaluated every seven days with SGA, MUST, and modified Nutrition Risk in Critically Ill (NUTRIC).
This study demonstrated that the incidence of 30-day mortality was 47.9%( 95% CI: 43.2 to 52.6). The hazards of death in patients with malnutrition increased by 40% as compared to well-nourished patients (aHR = 1.4, 95% CI: 1.33 to 2.56), and patients with diabetes mellitus had 4 times the hazards of death (aHR = 4.2, 95% CI: 2.12 to 8.28).
Malnutrition is prevalent in adult ICU patients and has been linked to a higher 30-day mortality and a more extended ICU stay. MUST, SGA, and NUTRIC, well-validated, practical, cost-effective, and non-invasive techniques for routinely evaluating nutritional status in critically ill patients, were good predictors of mortality.
营养不良是一个重大的公共卫生问题，会导致显著的死亡率和发病率，尤其是在发展中国家。然而，在撒哈拉以南非洲地区，营养不良的严重程度及其对重症监护病房（ICU）患者临床结局的影响仍需进一步研究，本研究旨在解决这些问题。
本研究的目的是评估营养不良对ICU患者临床结局的影响。
对436例ICU患者进行了一项前瞻性队列研究，其中218例为营养不良患者。在获得伦理批准后，对营养不良和营养良好的患者进行了30天的随访，以研究营养状况对临床结局及其决定因素的影响。入院时，采用主观全面评定法（SGA）和营养不良通用筛查工具（MUST）进行营养筛查和评估，在接下来的30天内，每7天用SGA、MUST和改良的危重症营养风险（NUTRIC）进行评估。
本研究表明，30天死亡率为47.9%（95%CI：43.2至52.6）。与营养良好的患者相比，营养不良患者的死亡风险增加了40%（调整后风险比[aHR]=1.4，95%CI：1.33至2.一56），糖尿病患者的死亡风险是其4倍（aHR=4.2，95%CI：2.12至8.28）。
营养不良在成年ICU患者中普遍存在，与30天更高的死亡率和更长的ICU住院时间有关。MUST、SGA和NUTRIC是用于常规评估危重症患者营养状况的经过充分验证、实用、具有成本效益且非侵入性的技术，是死亡率的良好预测指标。
