Measuring nutrition-related outcomes in a cohort of multi-trauma patients following intensive care unit discharge

J Hum Nutr Diet. 2020 Jun;33(3):414-422. doi: 10.1111/jhn.12719. Epub 2019 Dec 2.

Abstract

Background: Functional recovery is an important outcome for those who survive critical illness. The present study aimed to assess nutrition provision and nutrition-related outcomes in a multi-trauma cohort following intensive care unit (ICU) discharge.

Methods: The present study investigated a prospective cohort of patients discharged from an ICU, who had been admitted because of major trauma and required mechanical ventilation for at least 48 h. Nutrition-related outcomes, including body weight, quadriceps muscle layer thickness (QMLT), handgrip strength and subjective global assessment, were recorded on ICU discharge, days 5-7 post-ICU discharge and then weekly until hospital discharge. Nutrition intake was recorded for 5 days post-ICU discharge. Unless otherwise stated, data are presented as the mean (SD).

Results: Twenty-eight patients [75% males, 55 (22.5) years] were included. Intake met 64% (28%) of estimated energy and 72% (32%) of protein requirements over the 5 days post-ICU discharge, which was similar to over the ICU admission. From ICU admission to hospital discharge, the mean reduction in weight was 4.2 kg (95% confidence interval = 2.2-6.3, P < 0.001) and after ICU discharge, the mean reduction in weight and QMLT was 2.6 kg (95% confidence interval = 1.0-4.2, P = 0.004) and 0.23 cm (95% confidence interval = 0.06-0.4, P = 0.01), respectively.

Conclusions: Patients received less energy and protein than estimated requirements after ICU discharge. Weight loss and reduction in QMLT also occurred during this period.

Keywords: feasibility; intensive care unit; multi-trauma; muscle mass; nutrition.

MeSH terms

  • Adult
  • Aged
  • Body Weight / physiology
  • Critical Care Outcomes
  • Critical Illness
  • Diet Surveys
  • Eating / physiology*
  • Female
  • Hand Strength / physiology
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Nutritional Status / physiology*
  • Nutritional Support / statistics & numerical data*
  • Patient Admission / statistics & numerical data
  • Patient Discharge / statistics & numerical data*
  • Prospective Studies
  • Quadriceps Muscle / pathology
  • Recovery of Function
  • Respiration, Artificial
  • Wounds and Injuries / physiopathology*
  • Wounds and Injuries / therapy