{Reference Type}: Journal Article
{Title}: Nutritional support team intervention in surgical ICUs and its effect on nutrition delivery and quality in critically ill patients.
{Author}: Martinuzzi A;Crivelli A;Lopez A;Sgarzini D;Aragon V;Galeano F;Billinger MC;Doeyo M;Matano M;Salomone P;Cabrera D;Fabro AD;Manrique E;
{Journal}: Nutrition
{Volume}: 125
{Issue}: 0
{Year}: 2024 Sep 16
{Factor}: 4.893
{DOI}: 10.1016/j.nut.2024.112501
{Abstract}: BACKGROUND: Critically ill surgical patients pose one of the greatest challenges in achieving nutritional goals. Several published papers have demonstrated clear benefits when nutrition support (NS) is managed by a multidisciplinary nutrition support team (NST). We hypothesized that implementing a NST in a surgical intensive care unit (ICU) would increase the number of patients achieving their nutritional goals.
METHODS: Multicenter "BEFORE & AFTER" study. In the BEFORE phase, an audit of the previous state of NS was conducted in three ICUs without a NST.
METHODS: Implementation of a NST and protocol. In the AFTER phase, a new audit of NS was conducted. Continuous variables (presented as mean ± SD or median Q1-Q3) were tested using the t-test and Mann-Whitney U test. Categorical variables (presented as frequencies and percentages) were assessed using the chi-square test. A binomial logistic regression model was performed, with independent variables introduced using a stepwise forward method. A difference was considered to be significant with a two-sided P-value <0.05. Statistical analysis was conducted using IBM-SPSS 26.
RESULTS: A total of 83 patients were included in the BEFORE phase, and 85 in the AFTER phase. The latter group showed a higher frequency of nutritional risk and malnutrition (SGA B+C odds ratio 2.314, 95% CI 1.164-4.600). Laparoscopy was more frequently utilized as a surgical technique in the AFTER phase. No differences were observed in ICU and hospital LOS or 90 days' survival rates. Two variables remained independent factors to predict NS achievement: NST implementation (odds ratio 3.582, 95% CI 1.733-7.404), and surgical technique (odds ratio 3.231, 95% CI 1.312-7.959).
CONCLUSIONS: NST positively impacts the chance of achieving NS goals in critically ill surgical patients.