Kua Pei San, Albakri Musfirah, Tay Su Mei, Thong Phoebe Si-En, Xia Olivia Jiawen, Chua Wendelynn Hui Ping, Chong Kevin, Tan Nicholas Wei Kiat, Loh Xin Hui, Tan Jia Hui, Low Lian Leng
SingHealth Community Hospitals, 10 Hospital Blvd, Singapore 168582, Singapore.
SingHealth Centre for Population Health Research and Implementation, 10 Hospital Boulevard, #19-01 SingHealth Tower, Singapore 168582, Singapore.
Nutrients. 2025 Jun 27;17(13):2144. doi: 10.3390/nu17132144.
BACKGROUND/OBJECTIVES: Malnutrition is prevalent among hospitalized older adults with multimorbidity, leading to adverse health outcomes and increased healthcare costs. An accurate assessment of resting energy expenditure (REE) is crucial because an inaccurate estimation of energy needs may result in unintentional underfeeding or overfeeding, both of which can worsen nutritional status and clinical outcomes. While indirect calorimetry (IC) is the preferred method, its clinical applicability is limited. Prediction equations are commonly used, but their accuracy in older Asian patients with multimorbidity remains unclear.
This multicenter, cross-sectional study enrolled 400 patients aged ≥65 years from March to December 2023 in Outram Community Hospital (OCH) and Sengkang Community Hospital (SKCH). Participants' REE was measured using indirect calorimetry. We compared the performance of the newly developed novel prediction equations (PEs), derived from readily accessible or easily measured anthropometric data, against established equations. Statistical analysis included the calculation of R, the root mean square error (RMSE), and the intraclass correlation coefficient (ICC) to assess reliability and goodness of fit.
A high prevalence (85%) of multimorbidity was observed among the participants. REE increased progressively with body mass index (BMI) across all groups (865.6-1269.4 kcal in females; 889.1-1269.4 kcal in males). The novel PEs (RMSE: 186-191; ICC: 0.5-0.52) demonstrated improved accuracy and stronger reliability compared to conventional equations (RMSE: 222-258; ICC: 0.271-0.460).
Our newly developed PEs offer potentially valuable tools for precise REE estimation in hospitalized older Asian patients with multimorbidity. Further external validation and investigation in diverse populations are necessary to confirm these results.
背景/目的：营养不良在患有多种疾病的住院老年人中普遍存在，会导致不良健康后果并增加医疗成本。准确评估静息能量消耗（REE）至关重要，因为能量需求估算不准确可能导致非故意性喂养不足或喂养过度，这两者都会使营养状况和临床结局恶化。虽然间接测热法（IC）是首选方法，但其临床适用性有限。预测方程常用，但它们在患有多种疾病的亚洲老年患者中的准确性仍不明确。
这项多中心横断面研究于2023年3月至12月在欧南社区医院（OCH）和盛港社区医院（SKCH）招募了400名年龄≥65岁的患者。使用间接测热法测量参与者的REE。我们将新开发的、源自易于获取或易于测量的人体测量数据的新型预测方程（PEs）与既定方程的性能进行了比较。统计分析包括计算R、均方根误差（RMSE）和组内相关系数（ICC），以评估可靠性和拟合优度。
参与者中多种疾病的患病率很高（85%）。所有组的REE均随体重指数（BMI）逐渐增加（女性为865.6 - 1269.4千卡；男性为889.1 - 1269.4千卡）。与传统方程（RMSE：222 - 258；ICC：0.271 - 0.460）相比，新型PEs（RMSE：186 - 191；ICC：0.5 - 0.5）显示出更高的准确性和更强的可靠性。
我们新开发的PEs为精确估算患有多种疾病的住院亚洲老年患者的REE提供了潜在有价值的工具。需要在不同人群中进行进一步的外部验证和研究以证实这些结果。
