Clinical outcomes of inadequate calorie delivery and protein deficit in surgical intensive care patients

D. Dante Yeh, Miroslav P. Peev, Sadeq A. Quraishi, Polina Osler, Yuchiao Chang, Erin Gillis Rando, Caitlin Albano, Sharon Darak, George C. Velmahos

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Background Adequate nutritional therapy in critically ill patients is integral to optimal outcome. Objective To evaluate the association between cumulative macronutrient deficit and overall morbidity in surgical intensive care unit patients. Methods Adult patients receiving enteral nutrition for more than 72 hours were included if they had no previous admission to the surgical intensive care unit, had received no enteral feedings before admission, had no intestinal obstruction or ileus, and survived 72 hours or more after admission. Data on demographics, outcomes, and nutritional intake during the unit stay were collected for up to 14 days until oral intake began, discharge, or death. Outcome variables included lengths of stay in the hospital and intensive care unit, days with no mechanical ventilation, complications, and mortality. Results Of 94 participants, 71% were men, mean age was 63 years, and mean score on the Acute Physiology and Chronic Health Evaluation II was 14. Patients with high cumulative calorie deficit (≥= 6000 cal) and high protein deficit (≥= 300 g) had significantly fewer days with no mechanical ventilation (P < .001), longer unit stays (P < .001), longer hospital stays (P = .007), more total complications (P = .007), and more infectious complications (P = .009) than other participants. These associations remained significant in multivariable models after adjustments for age, sex, reason for admission, and propensity score of deficit. In-hospital and 30-day mortality did not differ. Conclusions Cumulative macronutrient deficits have important clinical outcomes in surgical intensive care patients.

Original languageEnglish (US)
Pages (from-to)318-326
Number of pages9
JournalAmerican Journal of Critical Care
Volume25
Issue number4
DOIs
StatePublished - 2016
Externally publishedYes

ASJC Scopus subject areas

  • Critical Care

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