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Title: Effects of nutrition factors on mortality and sepsis occurrence in a multicenter university-based surgical intensive care unit in Thailand (THAI-SICU study)
Authors: Supakrit Auiwattanakul
Kaweesak Chittawatanarat
Onuma Chaiwat
Sunthiti Morakul
Suneerat Kongsayreepong
Winai Ungpinitpong
Surakrant Yutthakasemsunt
Supawan Buranapin
Suranaree University of Technology
Surin Hospital
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Khon Kaen Regional Hospital
Faculty of Medicine, Siriraj Hospital, Mahidol University
Chiang Mai University
Keywords: Medicine
Issue Date: 1-Feb-2019
Citation: Nutrition. Vol.58, (2019), 94-99
Abstract: © 2018 Elsevier Ltd Objectives: The aim of this study was to demonstrate the role of nutrition factors on a 28-d mortality outcome and sepsis occurrence in surgical intensive care unit. Methods: The data was extracted from a THAI-SICU study that prospectively recruited participants (≥18 y of age) from three Thai surgical intensive care units (SICUs) of university-based hospitals. The demographic data and nutrition factors at SICU admission included energy delivery deficit, weight loss severity, route of energy delivery, and albumin and nutrition risk screening (NRS-2002). The outcomes were 28-d hospital mortality and sepsis occurrence. The statistical analysis was performed using Cox regression. Results: The study included 1503 eligible patients with a predominantly male population. The 28-d mortality and sepsis occurrences were 211 (14%) and 452 (30%), respectively. Regarding multivariable analysis, for mortality outcome, the protective effects of nutrition variables were higher body mass index (BMI; hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.68–0.99; P = 0.039), tube feeding (HR, 0.46; 95% CI, 0.26–0.83; P = 0.010), and a combination of enteral and parenteral nutrition (HR, 0.24; 95% CI, 0.07–0.77; P = 0.016). The harmful effects were severe weight loss (HR, 1.61; 95% CI, 1.16–2.22; P = 0.004), albumin ≤2.5 (HR, 2.15; 95% CI, 1.20–3.84; P = 0.010), and at risk according to NRS-2002 (HR, 1.34; 95% CI, 0.98–1.85; P = 0.071). For the sepsis occurrence, only tube feeding had a protective effect (HR, 0.58; 95% CI, 0.39–0.88; P = 0.009), and only albumin ≤2.5 had a harmful effect (HR, 1.71; 95% CI, 1.20–2.45; P = 0.003). Conclusion: Nutrition factors affecting the mortality or sepsis occurrence in this study were BMI, enteral feeding or combination with parenteral nutrition, severe weight loss, preadmission albumin ≤2.5, and at risk according to NRS-2002.
ISSN: 18731244
Appears in Collections:Scopus 2019

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