J Neurointensive Care.  2023 Oct;6(2):106-113. 10.32587/jnic.2023.00647.

Impact of Critical Care Registered Dietitian on Clinical Outcomes of Neurocritically Ill Patients

• Kwon H
• Kim HJ
• Ryu JA

• KMID: 2555089
• DOI: http://doi.org/10.32587/jnic.2023.00647

Abstract

Background
To investigate the impact of early nutrition intervention and a critical care registered dietitian on the outcomes of neurocritically ill patients.
Methods
Among neurosurgical patients admitted to the intensive care unit (ICU) in a tertiary hospital from January 2015 to December 2019, A critical care registered dietitian co-management was initiated on May 1, 2017. The primary endpoint was ICU mortality. Propensity score matching (PSM) was used to control selection bias and confounding factors.
Results
In this study, 1,386 patients were included. In the overall study population, nutrition was provided to 719 (51.9%) patients under the supervision of a registered dietitian. Early nutrition was performed for 356 (25.7%) patients. In the overall study population and the PSM adjusted population, rates of early parenteral nutrition (EPN) were higher in the groups managed by a registered dietitian than in the group without a registered dietitian (both p <0.001). In the overall and PSM adjusted population, the rates of ICU mortality, 28-day mortality, and in-hospital mortality were not significant different between two groups (all p > 0.05), but the group managed by a registered dietitian had a shorter hospital stay than the group without a registered dietitian (both p <0.02). In the multivariable analysis of the overall population and PSM adjusted population, EPN showed an association with ICU mortality.
Conclusions
The rate of EPN utilization increased after the implementation of co-management with a critical care registered dietitian, and the use of EPN was associated with lower ICU mortality in neurocritically ill patients.

Keyword

Enteral feeding; Prognosis; Neurosurgery; Intensive care unit