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Open AccessArticle

Association between Malnutrition and 28-Day Mortality and Intensive Care Length-of-Stay in the Critically ill: A Prospective Cohort Study

1
Discipline of Nutrition and Dietetics, School of Health Sciences, Flinders University, GPO Box 2100, Adelaide SA 5001 Australia
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Dietetics and Nutrition Department, Ng Teng Fong General Hospital, Singapore City 609606, Singapore
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Department of Respiratory Medicine, Ng Teng Fong General Hospital, Singapore City 609606, Singapore
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Saw Swee Hock School of Public Health, National University of Singapore, Singapore City 119077, Singapore
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(1), 10; https://doi.org/10.3390/nu10010010
Received: 9 November 2017 / Revised: 11 December 2017 / Accepted: 19 December 2017 / Published: 23 December 2017
There is limited evidence for the association between malnutrition and mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥ 24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients’ nutritional status within 48 h of ICU admission. Multivariable regressions were conducted in two ways: (1) presence versus absence of malnutrition, and (2) dose-dependent association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% were malnourished, and the 28-day mortality rate was 28.0%. Malnutrition was associated with an increased risk of 28-day mortality (adjusted Relative Risk 1.33 (95% Confidence Interval: 1.05–1.69)), and this risk increased with a greater degree of malnutrition (adjusted Relative Risk 1.08 (95% Confidence Interval: 1.00–1.16) for each 1-point decrease in the 7-point SGA). No significant association was found between malnutrition and ICU-LOS. The results of this study indicated a clear association between malnutrition and higher 28-day mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be replicated and hence requires further evaluation. View Full-Text
Keywords: malnutrition; nutritional assessment; mortality; length-of-stay; critical illness malnutrition; nutritional assessment; mortality; length-of-stay; critical illness
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Lew, C.C.H.; Wong, G.J.Y.; Cheung, K.P.; Chua, A.P.; Chong, M.F.F.; Miller, M. Association between Malnutrition and 28-Day Mortality and Intensive Care Length-of-Stay in the Critically ill: A Prospective Cohort Study. Nutrients 2018, 10, 10.

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