Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial
BackgroundThere is controversy over the optimal energy delivery in intensive care units (ICUs). In this study, we aimed to evaluate the association between different caloric adequacy assessed by a weight-based equation and short-term clinical outcomes in a cohort of critically ill patients.MethodsTh...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.902986/full |
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| author | Cheng Lv Xingwei Jiang Yi Long Zirui Liu Jiajia Lin Cuili Wu Xianghong Ye Ruiling Ye Yuxiu Liu Man Liu Yang Liu Wensong Chen Lin Gao Zhihui Tong Lu Ke Lu Ke Zhengying Jiang Weiqin Li Weiqin Li |
| author_facet | Cheng Lv Xingwei Jiang Yi Long Zirui Liu Jiajia Lin Cuili Wu Xianghong Ye Ruiling Ye Yuxiu Liu Man Liu Yang Liu Wensong Chen Lin Gao Zhihui Tong Lu Ke Lu Ke Zhengying Jiang Weiqin Li Weiqin Li |
| author_sort | Cheng Lv |
| collection | DOAJ |
| description | BackgroundThere is controversy over the optimal energy delivery in intensive care units (ICUs). In this study, we aimed to evaluate the association between different caloric adequacy assessed by a weight-based equation and short-term clinical outcomes in a cohort of critically ill patients.MethodsThis is a secondary analysis of a cluster-randomized controlled trial (N = 2,772). The energy requirement was estimated as 25 kcal/kg of body weight. The study subjects were divided into three groups according to their caloric adequacy as calculated by the mean energy delivered from days 3 to 7 of enrollment divided by the estimated energy requirements: (1) received < 70% of energy requirement (hypocaloric), (2) received 70–100% of energy requirement (normocaloric), and (3) received > 100% of energy requirement (hypercaloric). Cox proportional hazards models were used to analyze the association between caloric adequacy and 28-day mortality and time to discharge alive from the ICU.ResultsA total of 1,694 patients were included. Compared with normocaloric feeding, hypocaloric feeding significantly increased the risk of 28-day mortality (hazard ratio [HR] = 1.590, 95% confidence interval [CI]: 1.162–2.176, p = 0.004), while hypercaloric feeding did not. After controlling for potential confounders, the association remained valid (adjusted HR = 1.596, 95% CI: 1.150–2.215, p = 0.005). The caloric adequacy was not associated with time to discharge alive from the ICU in the unadjusted and the adjusted models.ConclusionEnergy delivery below 70% of the estimated energy requirement during days 3–7 of critical illness is associated with 28-day mortality.Clinical trial registration[https://www.isrctn.com/ISRCTN12233792], identifier [ISRCTN12233792]. |
| first_indexed | 2024-04-14T04:33:16Z |
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| id | doaj.art-b299e70f4ef54e0890fe0b8c1685c8f5 |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-14T04:33:16Z |
| publishDate | 2022-09-01 |
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| series | Frontiers in Nutrition |
| spelling | doaj.art-b299e70f4ef54e0890fe0b8c1685c8f52022-12-22T02:11:59ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-09-01910.3389/fnut.2022.902986902986Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trialCheng Lv0Xingwei Jiang1Yi Long2Zirui Liu3Jiajia Lin4Cuili Wu5Xianghong Ye6Ruiling Ye7Yuxiu Liu8Man Liu9Yang Liu10Wensong Chen11Lin Gao12Zhihui Tong13Lu Ke14Lu Ke15Zhengying Jiang16Weiqin Li17Weiqin Li18Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Southeast University, Nanjing, ChinaDepartment of Critical Care Medicine, Chongqing University Cancer Hospital, Chongqing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Critical Care Medicine, Chongqing University Cancer Hospital, Chongqing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaNational Institute of Healthcare Data Science, Nanjing University, Nanjing, ChinaDepartment of Critical Care Medicine, Chongqing University Cancer Hospital, Chongqing, ChinaDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaNational Institute of Healthcare Data Science, Nanjing University, Nanjing, ChinaBackgroundThere is controversy over the optimal energy delivery in intensive care units (ICUs). In this study, we aimed to evaluate the association between different caloric adequacy assessed by a weight-based equation and short-term clinical outcomes in a cohort of critically ill patients.MethodsThis is a secondary analysis of a cluster-randomized controlled trial (N = 2,772). The energy requirement was estimated as 25 kcal/kg of body weight. The study subjects were divided into three groups according to their caloric adequacy as calculated by the mean energy delivered from days 3 to 7 of enrollment divided by the estimated energy requirements: (1) received < 70% of energy requirement (hypocaloric), (2) received 70–100% of energy requirement (normocaloric), and (3) received > 100% of energy requirement (hypercaloric). Cox proportional hazards models were used to analyze the association between caloric adequacy and 28-day mortality and time to discharge alive from the ICU.ResultsA total of 1,694 patients were included. Compared with normocaloric feeding, hypocaloric feeding significantly increased the risk of 28-day mortality (hazard ratio [HR] = 1.590, 95% confidence interval [CI]: 1.162–2.176, p = 0.004), while hypercaloric feeding did not. After controlling for potential confounders, the association remained valid (adjusted HR = 1.596, 95% CI: 1.150–2.215, p = 0.005). The caloric adequacy was not associated with time to discharge alive from the ICU in the unadjusted and the adjusted models.ConclusionEnergy delivery below 70% of the estimated energy requirement during days 3–7 of critical illness is associated with 28-day mortality.Clinical trial registration[https://www.isrctn.com/ISRCTN12233792], identifier [ISRCTN12233792].https://www.frontiersin.org/articles/10.3389/fnut.2022.902986/fullenergy intakemortalityhypocaloric feedingresting energy expenditurecritical illness |
| spellingShingle | Cheng Lv Xingwei Jiang Yi Long Zirui Liu Jiajia Lin Cuili Wu Xianghong Ye Ruiling Ye Yuxiu Liu Man Liu Yang Liu Wensong Chen Lin Gao Zhihui Tong Lu Ke Lu Ke Zhengying Jiang Weiqin Li Weiqin Li Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial Frontiers in Nutrition energy intake mortality hypocaloric feeding resting energy expenditure critical illness |
| title | Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial |
| title_full | Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial |
| title_fullStr | Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial |
| title_full_unstemmed | Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial |
| title_short | Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial |
| title_sort | association between caloric adequacy and short term clinical outcomes in critically ill patients using a weight based equation secondary analysis of a cluster randomized controlled trial |
| topic | energy intake mortality hypocaloric feeding resting energy expenditure critical illness |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.902986/full |
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