Near-Target Caloric Intake in Critically Ill Medical-Surgical Patients Is Associated With Adverse Outcomes
Background: The objective of this study was to determine whether caloric intake independently influences mortality and morbidity of critically ill patients. Methods: The study was conducted as a nested cohort study within a randomized controlled trial in a tertiary care intensive care unit (ICU). Th...
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Veröffentlicht in: | JPEN. Journal of parenteral and enteral nutrition 2010-05, Vol.34 (3), p.280-288 |
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Sprache: | eng |
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Zusammenfassung: | Background: The objective of this study was to determine whether caloric intake independently influences mortality and morbidity of critically ill patients. Methods: The study was conducted as a nested cohort study within a randomized controlled trial in a tertiary care intensive care unit (ICU). The main exposure in the study was average caloric intake/target for the first 7 ICU days. The primary outcomes were ICU and hospital mortality. Secondary outcomes included ICU-acquired infections, ventilator-associated pneumonia (VAP), duration of mechanical ventilation days, and ICU and hospital length of stay (LOS). The authors divided patients (n = 523) into 3 tertiles according to the percentage of caloric intake/target: tertile I 64.6%. To adjust for potentially confounding variables, the authors assessed the association between caloric intake/target and the different outcomes using multivariate logistic regression for categorical outcomes (tertile I was used as reference) and multiple linear regression for continuous outcomes. Results: Tertile III was associated with higher adjusted hospital mortality, higher risk of ICU-acquired infections, and a trend toward higher VAP rate. Increasing caloric intake was independently associated with a significant increase in duration of mechanical ventilation, ICU LOS, and hospital LOS. Conclusions: The data demonstrate that near-target caloric intake is associated with significantly increased hospital mortality, ICU-acquired infections, mechanical ventilation duration, and ICU and hospital LOS. Further studies are needed to explore whether reducing caloric intake would improve the outcomes in critically ill patients. |
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ISSN: | 0148-6071 1941-2444 |
DOI: | 10.1177/0148607109353439 |