Prevalence and Impact of Malnutrition Risk on Outcomes in Critically Ill Patients with Traumatic Brain Injury and Stroke: A Retrospective Cohort Study Using Electronic Health Records.

Autor:	Shestopalov AE; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow 107031, Russia., Yakovleva AV; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow 107031, Russia., Yadgarov MY; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow 107031, Russia.; V. M. Gorbatov Federal Research Center for Food Systems, Russian Academy of Sciences, Moscow 109316, Russia., Sergeev IV; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow 107031, Russia., Kuzovlev AN; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow 107031, Russia.
Jazyk:	angličtina
Zdroj:	Nutrients [Nutrients] 2024 Jul 24; Vol. 16 (15). Date of Electronic Publication: 2024 Jul 24.
DOI:	10.3390/nu16152396
Abstrakt:	Background: Malnutrition is a critical concern in ICU settings. It is associated with increased morbidity and mortality, yet its prevalence and impact on clinical outcomes in patients with stroke and traumatic brain injury (TBI) remain underexplored. Objective: To evaluate the prevalence and impact of malnutrition risk on clinical outcomes in ICU patients with TBI, ischemic stroke, and hemorrhagic stroke, and to identify key risk factors associated with malnutrition risk. Methods: This retrospective cohort study utilized electronic health records encompassing ICU admissions from 2017 to 2023. Patients with either stroke or TBI were included, with malnutrition risk assessed using the prognostic nutritional index. Data were extracted and analyzed to determine patient characteristics, clinical and laboratory parameters, and outcomes. Results: This study included 1352 patients (267 TBI, 825 ischemic stroke, and 260 hemorrhagic stroke patients, >30% with pneumonia at admission). Severe malnutrition risk at admission was observed in over 60% of patients. Stroke patients, particularly those with hemorrhagic stroke, exhibited a higher risk of malnutrition compared to TBI patients. Malnutrition risk was associated with significantly higher hospital mortality and increased need for mechanical ventilation. Predictive factors for malnutrition risk included advanced age, higher SOFA scores, lower FOUR and GCS scores, and the presence of pneumonia at admission. Conclusions: Risk of malnutrition is highly prevalent among ICU patients with TBI, ischemic, and hemorrhagic stroke, significantly impacting mortality and other clinical outcomes. Identifying and managing malnutrition early in the ICU setting is crucial for improving patient outcomes. Further prospective, multicenter studies are needed to validate these findings and develop effective interventions.
Databáze:	MEDLINE
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