Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: a multicentre prospective observational study
<p><i>Background:</i> The COVID-19 pandemic highlighted major challenges with usual nutrition care processes, leading to reports of malnutrition and nutrition-related issues in these patients.</p> <p><i>Objective:</i> The objective of this study was to desc...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2023
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| _version_ | 1797112091758297088 |
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| author | Ridley, EJ Chapple, L-AS Ainscough, K Burrell, A Campbell, L Dux, C Ferrie, S Fetterplace, K Jamei, M King, V Neto, AS Nichol, A Osland, E Paul, E Summers, M Marshall, AP Udy, A |
| author_facet | Ridley, EJ Chapple, L-AS Ainscough, K Burrell, A Campbell, L Dux, C Ferrie, S Fetterplace, K Jamei, M King, V Neto, AS Nichol, A Osland, E Paul, E Summers, M Marshall, AP Udy, A |
| author_sort | Ridley, EJ |
| collection | OXFORD |
| description | <p><i>Background:</i> The COVID-19 pandemic highlighted major challenges with usual nutrition care processes, leading to reports of malnutrition and nutrition-related issues in these patients.</p>
<p><i>Objective:</i> The objective of this study was to describe nutrition-related service delivery practices across hospitalisation in critically ill patients with COVID-19 admitted to Australian intensive care units (ICUs) in the initial pandemic phase.</p>
<p><i>Methods:</i> This was a multicentre (nine site) observational study in Australia, linked with a national registry of critically ill patients with COVID-19. Adult patients with COVID-19 who were discharged to an acute ward following ICU admission were included over a 12-month period. Data are presented as n (%), median (interquartile range [IQR]), and odds ratio (OR [95% confidence interval {CI}]).</p>
<p><i>Results:</i> A total of 103 patients were included. Oral nutrition was the most common mode of nutrition (93 [93%]). In the ICU, there were 53 (52%) patients seen by a dietitian (median 4 [2–8] occasions) and malnutrition screening occurred in 51 (50%) patients most commonly with the malnutrition screening tool (50 [98%]). The odds of receiving a higher malnutrition screening tool score increased by 36% for every screening in the ICU (1st to 4th, OR: 1.39 [95% CI: 1.05–1.77] p = 0.018) (indicating increasing risk of malnutrition). On the ward, 51 (50.5%) patients were seen by a dietitian (median time to consult: 44 [22.5–75] hours post ICU discharge). The odds of dietetic consult increased by 39% every week while on the ward (OR: 1.39 [1.03–1.89], p = 0.034). Patients who received mechanical ventilation (MV) were more likely to receive dietetic input than those who never received MV.</p>
<p><i>Conclusions:</i> During the initial phases of the COVID-19 pandemic in Australia, approximately half of the patients included were seen by a dietitian. An increased number of malnutrition screens were associated with a higher risk score in the ICU and likelihood of dietetic consult increased if patients received MV and as length of ward stay increased.</p> |
| first_indexed | 2024-03-07T08:18:15Z |
| format | Journal article |
| id | oxford-uuid:25146d9a-af91-43ac-9742-7f5b44b7604f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:18:15Z |
| publishDate | 2023 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:25146d9a-af91-43ac-9742-7f5b44b7604f2024-01-22T09:12:10ZNutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: a multicentre prospective observational studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:25146d9a-af91-43ac-9742-7f5b44b7604fEnglishSymplectic ElementsElsevier2023Ridley, EJChapple, L-ASAinscough, KBurrell, ACampbell, LDux, CFerrie, SFetterplace, KJamei, MKing, VNeto, ASNichol, AOsland, EPaul, ESummers, MMarshall, APUdy, A<p><i>Background:</i> The COVID-19 pandemic highlighted major challenges with usual nutrition care processes, leading to reports of malnutrition and nutrition-related issues in these patients.</p> <p><i>Objective:</i> The objective of this study was to describe nutrition-related service delivery practices across hospitalisation in critically ill patients with COVID-19 admitted to Australian intensive care units (ICUs) in the initial pandemic phase.</p> <p><i>Methods:</i> This was a multicentre (nine site) observational study in Australia, linked with a national registry of critically ill patients with COVID-19. Adult patients with COVID-19 who were discharged to an acute ward following ICU admission were included over a 12-month period. Data are presented as n (%), median (interquartile range [IQR]), and odds ratio (OR [95% confidence interval {CI}]).</p> <p><i>Results:</i> A total of 103 patients were included. Oral nutrition was the most common mode of nutrition (93 [93%]). In the ICU, there were 53 (52%) patients seen by a dietitian (median 4 [2–8] occasions) and malnutrition screening occurred in 51 (50%) patients most commonly with the malnutrition screening tool (50 [98%]). The odds of receiving a higher malnutrition screening tool score increased by 36% for every screening in the ICU (1st to 4th, OR: 1.39 [95% CI: 1.05–1.77] p = 0.018) (indicating increasing risk of malnutrition). On the ward, 51 (50.5%) patients were seen by a dietitian (median time to consult: 44 [22.5–75] hours post ICU discharge). The odds of dietetic consult increased by 39% every week while on the ward (OR: 1.39 [1.03–1.89], p = 0.034). Patients who received mechanical ventilation (MV) were more likely to receive dietetic input than those who never received MV.</p> <p><i>Conclusions:</i> During the initial phases of the COVID-19 pandemic in Australia, approximately half of the patients included were seen by a dietitian. An increased number of malnutrition screens were associated with a higher risk score in the ICU and likelihood of dietetic consult increased if patients received MV and as length of ward stay increased.</p> |
| spellingShingle | Ridley, EJ Chapple, L-AS Ainscough, K Burrell, A Campbell, L Dux, C Ferrie, S Fetterplace, K Jamei, M King, V Neto, AS Nichol, A Osland, E Paul, E Summers, M Marshall, AP Udy, A Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: a multicentre prospective observational study |
| title | Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: a multicentre prospective observational study |
| title_full | Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: a multicentre prospective observational study |
| title_fullStr | Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: a multicentre prospective observational study |
| title_full_unstemmed | Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: a multicentre prospective observational study |
| title_short | Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: a multicentre prospective observational study |
| title_sort | nutrition care processes across hospitalisation in critically ill patients with covid 19 in australia a multicentre prospective observational study |
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