Nutritional status of patients hospitalized in the intensive care unit: A comprehensive report from Iranian hospitals, 2018

Zeinab Javid Mishamandani; Abdolreza Norouzy; Seyed Mohammadreza Hashemian; Batoul Khoundabi; Mohammad Rezaeisadrabadi; Mohammad Safarian; Mohsen Nematy; Omid Pournik; Tannaz Jamialahmadi; Mahdi Shadnoush; Omid Moradi Moghaddam; Farid Zand; Mohammad Taghi Beigmohammadi; Masoum Khoshfetrat; Elham Shafiei; Alireza Sedaghat

doi:10.1016/j.jcrc.2019.08.001

Nutritional status of patients hospitalized in the intensive care unit: A comprehensive report from Iranian hospitals, 2018

J Crit Care. 2019 Dec:54:151-158. doi: 10.1016/j.jcrc.2019.08.001. Epub 2019 Aug 6.

Authors

Zeinab Javid Mishamandani¹, Abdolreza Norouzy², Seyed Mohammadreza Hashemian³, Batoul Khoundabi⁴, Mohammad Rezaeisadrabadi⁵, Mohammad Safarian⁶, Mohsen Nematy⁶, Omid Pournik⁷, Tannaz Jamialahmadi¹, Mahdi Shadnoush⁸, Omid Moradi Moghaddam⁹, Farid Zand¹⁰, Mohammad Taghi Beigmohammadi¹¹, Masoum Khoshfetrat¹², Elham Shafiei¹⁰, Alireza Sedaghat¹³

Affiliations

¹ Student Research Committee, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
² Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
³ Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Iran Helal Institute of Applied-Science and Technology (Red Crescent Society of Iran), Tehran, Iran.
⁵ Internal Medicine Department, Student Research Committee, Shahid Beheshti University of Medical sciences, Tehran, Iran.
⁶ Biochemistry and Nutrition Department, Mashhad University of Medical Science, Mashhad, Iran.
⁷ Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.
⁸ Semnan University of Medical Sciences, Semnan, Iran; Department of Clinical Nutrition, Faculty of Nutrition & Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mshadnoush@gmail.com.
⁹ Trauma and Injury Research Center, Critical Care Department, Rasoul-e-Akram Complex Hospital, Iran University of Medical Sciences, Tehran, Iran.
¹⁰ Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
¹¹ Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
¹² Anesthesiology and Critical Care, Khatamolanbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
¹³ Faculty of Critical Care Medicine, Lung Disease Research Center, Mashhad university of Medical Sciences, Mashhad, Iran.

PMID: 31446233
DOI: 10.1016/j.jcrc.2019.08.001

Abstract

Introduction and aim: Malnutrition is a complication of hospitalization in critically ill patients. This event is occurred because of disease and therapeutic processes for curing the patients. Determination of nutritional status helps physicians and clinical nutritionists decide on the best regimen which should be prescribed for a patient. In the current study, we aimed to report the nutritional status ofpatientshospitalizedin the intensive care unit (ICU).

Method of study: We used three standard tolls, including Subjective global assessment (SGA), Nutrition Risk in the Critically Ill (NUTRIC) Score and nutrition risk screening (NRS) questionnaires via a multi-stage sampling for different ICU wards of 32 university hospitals in Iran. Frequencies and rates of nutritional scores, comparative studies, and determined agreement of scoring systems and nutritional status in any ward of hospitals were evaluated.

Results: There were 771 males and 540 female Cancer and trauma patients had the best and worst nutritional scores, respectively. Using NRS and NUTRIC, the low-risk scores were more frequent than thehigh-riskscores among ICU patients. SGA showed that most patients were in grades A (well nutritional status) or B (moderate nutritional status), andfew caseswere in grade C (poor nutritional status).The high-risk nutritional score wasobtained for older patients. NUTRIC and NRS had better agreement for diagnosis and differentiation of malnutrition than NUTRIC-SGA or NRS-SGA pairs. However, there was no strong agreement between the mentioned pairs.

Conclusion: Nutritional status of patients hospitalized in ICU wards in Iran wassomewhat better than other countries that this could be due to the highly observed guidelines of patient's care in Iran. Anyway,it is suggested that a more precise tool of nutritional scoresto be validated for patients hospitalized in ICU·In addition, better medical care needs a well evaluation of nutritional insufficiencies and what is necessary for compensation using complementary regimens.

Keywords: Intensive care unit; Iran; Malnutrition; NRS-2002; NUTRIC; SGA.

MeSH terms

Adult
Aged
Critical Illness / therapy*
Female
Humans
Intensive Care Units / statistics & numerical data*
Iran
Male
Malnutrition / diagnosis*
Middle Aged
Nutrition Assessment*
Nutritional Status
Nutritional Support / methods
Risk Assessment / methods