Impact of Malnutrition in Critically Ill Patients on Intensive Care Unit
Eldehily, K., Tawfik, M., Elkholy, M., Sabry, S. (2023). Impact of Malnutrition in Critically Ill Patients on Intensive Care Unit. EKB Journal Management System, 3(1), 57-69. doi: 10.21608/jicem.2023.244437.1024
Khalaf Ibrahim Eldehily; Mohamed Fouad Tawfik; Mohamed Bakry Elkholy; Sherif Medhat Sabry. "Impact of Malnutrition in Critically Ill Patients on Intensive Care Unit". EKB Journal Management System, 3, 1, 2023, 57-69. doi: 10.21608/jicem.2023.244437.1024
Eldehily, K., Tawfik, M., Elkholy, M., Sabry, S. (2023). 'Impact of Malnutrition in Critically Ill Patients on Intensive Care Unit', EKB Journal Management System, 3(1), pp. 57-69. doi: 10.21608/jicem.2023.244437.1024
Eldehily, K., Tawfik, M., Elkholy, M., Sabry, S. Impact of Malnutrition in Critically Ill Patients on Intensive Care Unit. EKB Journal Management System, 2023; 3(1): 57-69. doi: 10.21608/jicem.2023.244437.1024

Impact of Malnutrition in Critically Ill Patients on Intensive Care Unit

The Egyptian Journal of Intensive Care and Emergency Medicine
Volume 3, Issue 1, June 2023, Page 57-69  XML PDF (558.58 K)
Document Type: Original papers
DOI: 10.21608/jicem.2023.244437.1024
View on SCiNiTO View on SCiNiTO
Authors
Khalaf Ibrahim Eldehily; Mohamed Fouad Tawfik; Mohamed Bakry Elkholy; Sherif Medhat Sabry email
Critical Care Medicine Department, Faculty of Medicine, Beni-Seuf University, Beni-Suef, Egypt
Abstract
Background: Malnutrition is one of the major problems during the stay in the intensive care units (ICUs). Critically ill patients are at high risk of developing malnutrition, associated with worse clinical outcomes. This work aimed to detect the severity of malnutrition in critically ill patients by using the Subjective Global Assessment score (SGA) and its association with the length of ICU stay and mortality. Methods: This prospective cohort observational study was carried out on 50 patients aged >18 years old, both sexes, with clinical criteria of malnutrition, involuntary weight loss, low body mass index, decreased mass of muscles, history of decreased food intake or absorption and inflammation or acute disease or injury with severe inflammation. All patients were subjected to mid-arm circumference (MAC), triceps skin fold (TSF) and hand grip strength . Results: The mean length of stay in ICU was 13.5±11.2 days. 18 patients needed mechanical ventilation (MV) representing 36% of cases with mean ventilation days 10.7±7.1, and the mortality proportion 34%. A statistically substantial correlation existed between mortality, smaller MAC (P = 0.001), and TSF (P = 0.001). In addition, the Handgrip was lower in mortality but didn’t reach statistical significance (P = 0.091). A substantial association existed between the advanced grade of SGA (grade C) and mortality (P = 0.001). Conclusions: There was a strong association between mortality in critically ill patients and smaller triceps skin fold, MAC. Severe malnutrition in critically ill patients SGA (grade C) was significantly associated with mortality and the need for MV .
Keywords
Critically Ill; Intensive Care Unit; Subjective Global Assessment; Malnutrition
References
  1. Chen Y, Michalak M, Agellon LB. Importance of nutrients and nutrient metabolism on human health. Yale J Biol Med. 2018;91:95-103.
  2. Saunders J, Smith T. Malnutrition: causes and consequences. Clin Med 2010;10:624-7.
  3. Clemente-Suárez VJ, Ramírez-Goerke MI, Redondo-Flórez L, Beltrán-Velasco AI, Martín-Rodríguez A, Ramos-Campo DJ, et al. The impact of anorexia nervosa and the basis for non-pharmacological interventions. Nutrients. 2023;15:2594-5.
  4. Serón-Arbeloa C, Labarta-Monzón L, Puzo-Foncillas J, Mallor-Bonet T, Lafita-López A, Bueno-Vidales N, et al. Malnutrition screening and assessment. Nutrients. 2022;14:30-50.
  5. Kopp Lugli A, de Watteville A, Hollinger A, Goetz N, Heidegger C. Medical nutrition therapy in critically ill patients treated on intensive and intermediate care units: A literature review. J Clin Med. 2019;8:66-70.
  6. Pardo E, Lescot T, Preiser JC, Massanet P, Pons A, Jaber S, et al. Association between early nutrition support and 28-day mortality in critically ill patients: the FRANS prospective nutrition cohort study. Crit Care. 2023;27:7.
  7. Narayan SK, Gudivada KK, Krishna B. Assessment of nutritional status in the critically ill. Indian J Crit Care Med. 2020;24:152-6.
  8. Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. J Clin Med. 2019;8:30-60.
  9. Enass Aboshoushah, Jumanah Albarakati, Faisal Almajayishi. Identification, prevention and management of malnutrition in the critically ill patients. J Health Sci. 2022;2:1658-8967.
  10. Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11:8-13.
  11. Tartari RF, Ulbrich-Kulczynski JM, Filho AF. Measurement of mid-arm muscle circumference and prognosis in stage IV non-small cell lung cancer patients. Oncol Lett. 2013;5:1063-7.
  12. Valente KP, Almeida BL, Lazzarini TR, Souza VF, Ribeiro TSC, Guedes de Moraes RA, et al. Association of adductor pollicis muscle thickness and handgrip strength with nutritional status in cancer patients. PLoS One. 2019;14:220-334.
  13. Domenech-Briz V, Gea-Caballero V, Czapla M, Chover-Sierra E, Juárez-Vela R, Santolalla Arnedo I, et al. Importance of nutritional assessment tools in the critically ill patient: A systematic review. Frontiers in Nutrition. 2023;9.
  14. Ferrie S, Weiss NB, Chau HY, Torkel S, Stepniewski ME. Association of Subjective Global Assessment with outcomes in the intensive care unit: A retrospective cohort study. Nutr Diet. 2022;79:572-81.
  15. Vamvakari K, Evangelou I, Kalafati IP, Kipouros M, Kosti RI, Kasti AN, et al. Assessment of nutritional status using objective and subjective methods in Greek patients with cancer. memo-Magazine of European Medical Oncology. 2023;9:1-8.
  16. Gürsoy C, Alkan A, Kaya Çubuk E, Karcı E, Yılmaz HO, Çakır T. Rectus abdominis and rectus femoris muscle thickness in determining nutritional risk in critically ill patients: a prospective cohort study in Turkey. BMJ Open. 2023;13:e071796.
  17. Zaki D, Zakaria DM, Abd El-Galil HM. Prevalence of malnutrition among hospitalized medical intensive care unit patients in a university hospital, Cairo, Egypt: Hospital based survey. J Intern Med. 2018;7:54-9.
  18. Santer D, Schneider N, de Carvalho YSS, de Souza Bortolini RV, Silva FM, Franken DL, et al. The association between reduced calf and mid-arm circumferences and ICU mortality in critically ill COVID-19 patients. Clin Nutr ESPEN. 2023;54:45-51.
  19. Matsumoto T, Yoshikawa R, Harada R, Fujii Y, Adachi A, Onishi H, et al. Predictors of Activities of Daily Living in Intensive Care Unit Survivors: A Propensity Score Matching Analysis. Prog Rehabil Med. 2023;8:20230010.
  20. Wu T, Xu H, Zou Y, Cui J, Xu K, Zhou M, et al. Mid-arm muscle circumference or body weight-standardized hand grip strength in the glim superiorly predicts survival in chinese colorectal cancer patients. Nutrients. 2022;14:5166-7.
Statistics
Article View: 297
PDF Download: 466