Association between malnutrition and 28-day mortality and intensive care length-of-stay in the critically ill: A prospective cohort study

Charles Chin Han Lew, Gabriel Jun Yung Wong, Ka Po Cheung, Ai Ping Chua, Mary Foong Fong Chong, Michelle Miller

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    23 Citations (Scopus)

    Abstract

    There is limited evidence for the association between malnutrition and mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥ 24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients’ nutritional status within 48 h of ICU admission. Multivariable regressions were conducted in two ways: (1) presence versus absence of malnutrition, and (2) dose-dependent association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% were malnourished, and the 28-day mortality rate was 28.0%. Malnutrition was associated with an increased risk of 28-day mortality (adjusted Relative Risk 1.33 (95% Confidence Interval: 1.05-1.69)), and this risk increased with a greater degree of malnutrition (adjusted Relative Risk 1.08 (95% Confidence Interval: 1.00-1.16) for each 1-point decrease in the 7-point SGA). No significant association was found between malnutrition and ICU-LOS. The results of this study indicated a clear association between malnutrition and higher 28-day mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be replicated and hence requires further evaluation.

    Original languageEnglish
    Article number10
    Number of pages9
    JournalNutrients
    Volume10
    Issue number1
    DOIs
    Publication statusPublished - Jan 2018

    Keywords

    • Critical illness
    • Length-of-stay
    • Malnutrition
    • Mortality
    • Nutritional assessment

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