Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial.
Front Nutr
; 9: 902986, 2022.
Article
em En
| MEDLINE
| ID: mdl-36118758
ABSTRACT
Background:
There is controversy over the optimal energy delivery in intensive care units (ICUs). In this study, we aimed to evaluate the association between different caloric adequacy assessed by a weight-based equation and short-term clinical outcomes in a cohort of critically ill patients.Methods:
This is a secondary analysis of a cluster-randomized controlled trial (N = 2,772). The energy requirement was estimated as 25 kcal/kg of body weight. The study subjects were divided into three groups according to their caloric adequacy as calculated by the mean energy delivered from days 3 to 7 of enrollment divided by the estimated energy requirements (1) received < 70% of energy requirement (hypocaloric), (2) received 70-100% of energy requirement (normocaloric), and (3) received > 100% of energy requirement (hypercaloric). Cox proportional hazards models were used to analyze the association between caloric adequacy and 28-day mortality and time to discharge alive from the ICU.Results:
A total of 1,694 patients were included. Compared with normocaloric feeding, hypocaloric feeding significantly increased the risk of 28-day mortality (hazard ratio [HR] = 1.590, 95% confidence interval [CI] 1.162-2.176, p = 0.004), while hypercaloric feeding did not. After controlling for potential confounders, the association remained valid (adjusted HR = 1.596, 95% CI 1.150-2.215, p = 0.005). The caloric adequacy was not associated with time to discharge alive from the ICU in the unadjusted and the adjusted models.Conclusion:
Energy delivery below 70% of the estimated energy requirement during days 3-7 of critical illness is associated with 28-day mortality. Clinical trial registration [https//www.isrctn.com/ISRCTN12233792], identifier [ISRCTN12233792].
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Risk_factors_studies
Idioma:
En
Revista:
Front Nutr
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
China