616 Quantification of Nutritional Intakes in Burn Outpatients

Abstract

Abstract Introduction Adequate nutrition is essential for wound healing, especially burns. Data on nutritional intakes of burn outpatients (BO) are rare, as well as dedicated guidelines. Objectives of this observational study were to quantify actual nutritional intakes in BO and to search for risk factors of inadequate intakes. Methods The study was conducted during 35 weeks in a university burn outpatient clinic. Adults treated exclusively on an outpatient basis were enrolled. Their average daily food intakes were evaluated by a dietician using a ten-point visual assessment of consumed portions during the last meal (SEFI tool) and a food anamnesis. Intakes (calories (Cal), proteins (P), omega-3 and-6 fatty acids (FA), selenium, copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg), iron, vitamins (vit) A, C, D and E) were compared to national recommended dietary allowances (RDA) for healthy subjects. Actual, ideal or adjusted weight was used as required according to body mass index (BMI). Micronutrients intakes were also calculated in a simulated situation where patients would have received a daily commercial tablet containing multiple vitamins and minerals. Data are expressed as median (P25-P75). Results Forty two patients (57% male, age 45 (34–56)y, BMI 25.9 (23.5–28.9)kg/m2, burn surface area (BSA) 2 (1–3)%) were included. Daily Cal and P intakes were 23.6 (19.6 – 29.9) kcal/kg and 1.08 (0.76 – 1.45) g/kg respectively. Inadequate intakes (defined as < 66% RDA) of Cal and P were observed in 36% and 14% of BO, respectively. More than half of BO had inadequate intakes of omega-3 and -6 FA, Ca, Mg, Cu, and vit A, C, D and E. A SEFI < 7 was associated with insufficient intakes in both Cal and P. Probability for patients to have insufficient intakes in both Cal and P was about 6 times more per 1% BSA. No risk factors were detected for insufficient micronutrients intakes. Inadequate intakes were not associated with prolonged healing. Seven BO already took vit C or D, or multiple micronutrients. With daily micronutrients supplements, the others (35/42) would have reached micronutrients RDA, excepting for Ca, Mg, Cu and vit D. Inadequate Ca and vit D intakes would have persisted in 57% and 37% of the supplemented patients, respectively. Conclusions Adequacy of Cal and P intakes should be assessed in BO patients with SEFI < 7 or with substantial BSA. Micronutrients intakes, particularly vitamins, were frequently lower than RDA but could be efficiently increased through oral multiple supplementation. With regards to its pleiotropic effects, vit D should probably be supplemented separately in all BO. Applicability of Research to Practice Raising awareness about insufficient micronutrients intakes in a number of BO.