Ann Clin Nutr Metab.  2023 Dec;15(3):97-108. 10.15747/ACNM.2023.15.3.97.

Comparative assessment of nutritional characteristics of critically ill patients at admission and discharge from the neurosurgical intensive care unit in Korea: a comparison study

• Bae E
• Jang J
• Kim M
• Kang S
• Son K
• Kim T
• Lim H

• KMID: 2548776
• DOI: http://doi.org/10.15747/ACNM.2023.15.3.97

Abstract

Purpose
Patients in neurosurgical (NS) intensive care units (ICUs) experience considerable energy and protein deficits associated with adverse outcomes. This study aimed to compare the nutritional status of patients at admission to (baseline) and discharge from the NS ICU.
Methods
This was a single-center, retrospective, before and after study of patients admitted in the NS ICU of the CHA Bundang Medical Center, from January 31, 2019, to February 28, 2020. All anthropometric data, biochemical data, clinical data, and dietary data were collected during the NS ICU stay. Specifically, we investigated the cumulative caloric deficit rate, phase angle and skeletal muscle index as indicators of lean muscle mass, and nitrogen balance according to demographic and clinical characteristics.
Results
A total of 140 NS patients were studied. Calf circumference decreased from 31.4±4.2 cm at baseline to 30.2±4.0 cm at discharge (P<0.001). Energy supply rate increased from 44.4% at baseline to 89.2% at discharge. Phase angle (PhA) patients with an modified Nutrition Risk in the Critically ill (mNUTRIC) score≤5 group had significantly lower PhA values than those with an mNUTRIC score>5 (P=0.005).
Conclusion
Although clinical and dietary parameters of patients in the NS ICU improved from baseline to discharge, anthropometric and biochemical markers of lean muscle mass and nutritional status decreased. PhA and nitrogen balance difference values were significantly different between those with an mNUTRIC score≤5 and those with an mNUTRIC score>5. These data indicate that the nutritional risk of critically ill patients increases during hospitalization in the NS ICU.

Keyword

Anthropometry; Intensive care units; Neurosurgery; Nutritional assessment; Skinfold thickness