Higher Energy and Protein Intake from Enteral Nutrition May Reduce Hospital Mortality in Mechanically Ventilated Critically Ill Elderly Patients

Abstract

Summary Background The objective of this study was to investigate whether the nutrition intake from enteral nutrition (EN) and parenteral nutrition (PN) created a better clinical outcome than EN alone in high nutritional risk (HNR) mechanically ventilated critically ill elderly patients. Methods We included patients ≥ 65 years on mechanical ventilation ≥ 48 h and received EN. Nutritional status was evaluated by Modify NUTrition Risk in Critical ill score (mNUTRIC). We calculated the energy and protein requirements as Harris-Benedict equation × 1.0–1.3 and 1.0–2.0 gm/kg body weight respectively. Nutrition intake from EN and PN was recorded within 7 days. ICU and hospital mortalities in HNR elderly patients who could achieve more or less 80% prescribed nutrition were compared. Result Among 190 critically ill elderly patients, 173 (91.1%) HNR patients had mNUTRIC ≥ 5. HNR patients who achieved ≥80% prescribed calorie had lower ICU mortality (13.5% vs 25.8%; P = 0.04) and hospital mortality (23.4% vs 40.3%; P = 0.02) compared to those who achieved Conclusion Very high percentage (91.1%) of medical intensive care (MICU) elderly patients were in HNR. Those who EN calorie achieved ≥80% prescription had lower ICU and hospital mortality. Increased EN protein intake only lowered hospital mortality.