Determinants of malnutrition in critically ill patients admitting to ICU in Iran

Abstract

Background and aim: Patients in Intensive Care Unit (ICU) face with major challenges including malnutrition, immune dysfunction, severe infections, multiple organ dysfunction and death. This study was undertaken to evaluate the nutritional status of ICU inpatients receiving nutritional support in Isfahan, Iran. Methods: This cross sectional study was conducted among patients admitted to medical and surgical ICU wards. Nutritional status was assessed via measuring anthropometric indices, laboratory data and medical history by a registered dietitian. Biochemical indicators representing blood values, glycemic status and lipid profile, pulmonary, hepatic and renal function were measured. Malnutrition was assessed according to albumin levels and ideal body weight within 4 categories. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS, version 16). Results: In this study, decreased level of albumin, total protein and phosphorus were related to malnutrition. Albumin and total protein levels were significantly different within 4 subcategories of patients with more than 90% of ideal body weight (p<0,001). Patients with good nutritional status had higher albumin and total protein levels than malnourished ones (p<0,001). No significant relationship was observed between body mass index (BMI), creatinine, blood urea nitrogen (BUN), potassium, magnesium and malnutrition. Conclusions: Malnutrition is prevalent among ICU patients which has the detrimental impact on rehabilitation and mobilization of the patients and extends time of hospitalization. Nutritional status should be monitored and corrected since the start of disease, preferably in ICU. Further studies are necessary to determine the best methods to define nutritional status of patients. In addition, well-designed clinical trials are needed to clarify all aspects of nutritional supplementation.