Preprint Article Version 1 This version is not peer-reviewed

Association between Malnutrition and Hospital Mortality and Duration of Intensive Care Unit Admission in the Critically Ill: A Prospective Cohort Study

Version 1 : Received: 9 November 2017 / Approved: 10 November 2017 / Online: 10 November 2017 (06:29:59 CET)

A peer-reviewed article of this Preprint also exists.

Lew, C.C.H.; Wong, G.J.Y.; Cheung, K.P.; Chua, A.P.; Chong, M.F.F.; Miller, M. Association between Malnutrition and 28-Day Mortality and Intensive Care Length-of-Stay in the Critically ill: A Prospective Cohort Study. Nutrients 2018, 10, 10. Lew, C.C.H.; Wong, G.J.Y.; Cheung, K.P.; Chua, A.P.; Chong, M.F.F.; Miller, M. Association between Malnutrition and 28-Day Mortality and Intensive Care Length-of-Stay in the Critically ill: A Prospective Cohort Study. Nutrients 2018, 10, 10.

Journal reference: Nutrients 2018, 10, 10
DOI: 10.3390/nu10010010

Abstract

There is limited evidence for the association between malnutrition and hospital mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients’ nutritional status within 48 hours of ICU admission. Multivariate analyses were conducted in two ways: 1) presence versus absence of malnutrition, and 2) dose-dependent association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% were malnourished, and 29.6% died before hospital discharge. Malnutrition was associated with an increased risk of hospital mortality [adjusted-RR 1.39 (95%CI: 1.10–1.76)], and this risk increased with a greater degree of malnutrition [adjusted-RR 1.09 (95%CI: 1.01–1.18) for each 1-point decrease in the 7-point SGA]. No significant association was found between malnutrition and ICU-LOS. Conclusion: There was a clear association between malnutrition and higher hospital mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be replicated and hence requires further evaluation.

Subject Areas

malnutrition; nutritional assessment; hospital mortality; length of stay; critical illness

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