Premium
Association Between AND‐ASPEN Malnutrition Criteria and Hospital Mortality in Critically Ill Trauma Patients: A Prospective Cohort Study
Author(s) -
Ceniccola Guilherme Duprat,
Okamura Aline Bassetto,
Sepúlveda Neta Jeane da Silva,
Lima Fernanda Cintra,
Santos de Deus Andressa Cristina,
Oliveira Jessica Amarante,
dos Santos Sabrina Souza Martins,
Sousa Rildo Batista,
BritoAshurst Ione
Publication year - 2020
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1795
Subject(s) - malnutrition , medicine , wasting , intensive care unit , prospective cohort study , population , parenteral nutrition , intensive care medicine , odds ratio , cohort study , emergency medicine , pediatrics , environmental health
Background Malnutrition is prevalent in trauma victims because of intense muscle wasting triggered by traumatic events and is a mortality risk. The Academy of Nutrition and Dietetics–American Society for Parenteral and Enteral Nutrition (AND‐ASPEN) tool has the potential to diagnose malnutrition in this population. This study aims to evaluate this criterion as a malnutrition diagnostic tool and as a hospital mortality predictor in critically ill trauma patients. Methods We performed an observational prospective cohort study from April 2015 to February 2017 in a Brazilian hospital. Patients were >18 years old, remained in the intensive care unit (ICU) >48 hours, and had completed data regarding the recommended clinical characteristics (RCCs) for malnutrition. The main exposure of interest was malnutrition assessed by a specialist dietitian using AND‐ASPEN. The primary outcome was all causes of mortality during hospital stay. Secondary outcome was the RCCs assessment, to predict malnutrition and hospital mortality. Results Included were 414 trauma patients. Malnutrition prevalence was 26.8% at ICU admission. The main analysis showed that malnutrition increases mortality chances 1.96 times (95% CI, 1.13–3.30; P = .015). Secondary analysis showed that all 5 RCCs were significantly associated with malnutrition. The only RCC associated with mortality was energy intake (odds ratio 1.5; 95% CI, 1.1–2.0; P = .008). Conclusions AND‐ASPEN criterion is a feasible and accurate method to recognize malnutrition and predict hospital mortality when applied by trained dietitians for the critical care trauma population. Further studies are needed considering patient subgroups such as obese and elderly.