2026-04-05T10:40:03Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/72282025-10-24T10:59:56Zcom_2072_451665com_2072_378040col_2072_451666
RECERCAT
author
Grau, Teodoro
author
Mor-Marco, Esther
author
Iglesias-Rodriguez, Rayden
author
Lopez-Delgado, Juan Carlos
author
Servia Goixart, Luis
author
Trujillano, Javier
author
Bordeje, Mª Luisa
2025-10-24T10:59:56Z
2025-10-24T10:59:56Z
2022-03-22T13:12:49Z2022-03-22T13:12:49Z2022-02-01
http://hdl.handle.net/11351/7228
Enteral nutrition; Intensive care unit; MortalityNutrició enteral; Unitat de Cures Intensives; MortalitatNutrición enteral; Unidad de Cuidados Intensivos; MortalidadBackground & aims: The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients.
Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported.
Results: We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P < 0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8 ± 2.1 vs 5.2 ± 1.7; P < 0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008-1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036-1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025-1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168-4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015-1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263-0.977; P=0.042).
Conclusions: Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes.
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess
Nutrició enteral
Medicina intensiva
Mortalitat
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Feeding Methods::Enteral Nutrition
HEALTH SURVEILLANCE::Health Surveillance of Health Services::Health Facilities::Hospitals::Hospital Units::Intensive Care Units
PUBLIC HEALTH::Epidemiology and Biostatistics::Biostatistics::Information Storage and Retrieval::Mortality Registries
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::métodos de alimentación::nutrición enteral
VIGILANCIA SANITARIA::vigilancia sanitaria de los servicios de salud::centros sanitarios::hospitales::unidades hospitalarias::unidades de cuidados intensivos
SALUD PÚBLICA::epidemiología y bioestadística::bioestadística::almacenamiento y recuperación de la información::registros de mortalidad
Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study): Does nutrition really affect ICU mortality?
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion