Nutrition-impacting symptoms in survivors of critical illness: A descriptive cohort study

Background: Oral intake is the most common route of nutrition following intensive care unit (ICU) discharge; yet is associated with inadequate intake, and barriers are largely unknown. This study aimed to determine the prevalence and severity of symptoms that may impact oral intake (termed nutrition-impacting symptoms) in ICU survivors. 

Methods: A single-center descriptive cohort study quantified prevalence and severity of nutrition-impacting symptoms in ICU survivors at ICU (T1) and hospital (T2) discharge and at 1 month posthospital discharge (T3) via patient-reported questionnaires. Secondary outcomes were nutrition status (via Subjective Global Assessment) and energy and protein intakes (via 24-h recall). Data are median (IQR) or (percent). 

Results: Forty-nine ICU survivors (64 [51–71] years; 31% female) were included. The most prevalent nutrition-impacting symptoms were T1: tiredness (96%), loss of appetite (82%), and early satiety (82%); T2: tiredness (93%), early satiety (88%), and dry mouth (78%); and T3: tiredness (95%), early satiety (81%), and low mood (66%). Nutrition-impacting symptoms with the greatest severity (out of 10, higher equates to worse) at each time point were T1: tiredness, constipation, diarrhea, nausea (all 8 [5–10]); T2: tiredness and constipation (both 7 [5–8]); and T3: tiredness (6 [3–8]) and diarrhea (6 [2–7]). Malnutrition rates were 34% at T1. Energy and protein intakes were T1: 1046 [548–1481] kcal, 45.2 [23.9–61.0] g; T2: 1370 [958–1962] kcal, 70.9 [39.0–92.2] g; T3: 1580 [1168–2042] kcal, 45.2 [54.6–100.4] g. 

Conclusions: ICU survivors experience multiple nutrition-impacting symptoms of varying prevalence and severity, which improve across the post-ICU continuum.