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

Leila Azadbakht; Saeid Abbasi; Maryam Hajishafiee; Awat Feizi; Gholamreza Mohajeri; Felorens Nemani; Mohammad Hassan Entezari; Rezvan Kazemi; Gholamreza Askari; Fatemeh Samadanian; Peyman Adibi

doi:10.23751/pn.v21i1-S.5943

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

Authors

Leila Azadbakht 1. Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran 2. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran 3. Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 4. Department of Community Nutrition, School of Nutritional Science and Dietetics , Tehran University of Medical Sciences, Tehran, Iran
Saeid Abbasi School of Medicine, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Maryam Hajishafiee Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran2. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran; Adelaide Medical School, Adelaide, South Australia 5000, Australia
Awat Feizi Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences,and Isfahan Endocrine and Metabolism Research Center, Isfahan 81745-151, Iran
Gholamreza Mohajeri School of Medicine, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Felorens Nemani 1. Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran 2. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Mohammad Hassan Entezari 1. Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran 2. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Rezvan Kazemi Isfahan University of Medical Sciences
Gholamreza Askari 1. Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran 2. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Fatemeh Samadanian 1. Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran 2. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Peyman Adibi Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan 81745-319, Iran

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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.