In:
Journal of Parenteral and Enteral Nutrition, Wiley, Vol. 44, No. 2 ( 2020-02), p. 213-219
Abstract:
The aim of this project was to investigate the prevalence of nutrition consultation (NC) in U.S. intensive care units (ICUs) and to examine its association with patient outcomes. Methods Data from the Healthcare Cost and Utilization Project's state inpatient databases was utilized from 2010 – 2014. A multilevel logistic regression model was used to evaluate the relationship between NC and clinical outcomes. Results Institutional ICU NC rates varied significantly (mean: 14%, range: 0.1%–73%). Significant variation among underlying disease processes was identified, with burn patients having the highest consult rate ( P 〈 0.001, mean: 6%, range: 2%–25%). ICU patients who received NC had significantly lower in‐hospital mortality (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.48–0.74, P 〈 0.001), as did the subset with malnutrition (OR 0.72, 95% CI 0.53–0.99, P = 0.047) and the subset with concomitant physical therapy consultation (OR 0.53, 95% CI 0.38–0.74, P 〈 0.001). NC was associated with significantly lower rates of intubation, pulmonary failure, pneumonia, and gastrointestinal bleeding ( P 〈 0.05). Furthermore, patients who received NC were more likely to receive enteral or parenteral nutrition (ENPN) (OR 1.8, 95% CI 1.4–2.3, P 〈 0.001). Patients who received follow‐up NC were even more likely to receive ENPN (OR 3.0, 95% CI 2.1–4.2, P 〈 0.001). Conclusions Rates of NC were low in critically ill patients. This study suggests that increased utilization of NC in critically ill patients may be associated with improved clinical outcomes.
Type of Medium:
Online Resource
ISSN:
0148-6071
,
1941-2444
Language:
English
Publisher:
Wiley
Publication Date:
2020
detail.hit.zdb_id:
2170060-6
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