P019 NUTRITIONAL SUPPORT IN CRITICALLY ILL PATIENTS DECREASES THE LENGTH OF STAY AND THE MORTALITY RATE IN THE ICU

Abstract

Rationale: Parenteral nutrition (PN) and enteral nutrition (EN) represent the nutritional support (NS) of critically ill patients (CP). However, the association between NS, with diagnosis (D), age (A), length of stay (LS), over the mortality rate (M) has not been established. Methods: In total, 305 CP with PN as the main NS were included. Four groups of NS were defined, 1) patients with early PN (in the first 48 hours in the ICU); 2) patients with late PN & EN; 3) patients with early PN & EN; 4) patients with late PN. Groups of D were defined; 1) acute severe pancreatitis; 2) metabolic disease without sepsis; 3) surgical without sepsis; 4) surgical with sepsis; 5) metabolic disease with sepsis; 6) trauma; 7) burned. Three groups of age were established, 18 40, 41 65 and 66 years old or more. The LS was divided in short; 10 days or less, medium; between 11 to 20 days and large; 21 days or more. Mortality or survival was observed. Chi-squared test and logistic regression models were used. Results: NS presented was: NS 1) for 36.4%; 2) 18.7%; 3) 37.7% and 4) 7.2%. The correlation between NS and D was: CP with NS 1&3 had D 3 & 4, in contrast CP with NS 2 & 4 had D 2 & 3, p < 0.001. The relation between NS and A was p = 0.70. An Association between NS and LS was founded: CP with NS 2 & 4 had large LS; compared with CP with NS 1 & 3 who had short LS, p < 0.001. The M was 23.9%. M was not associated with D, p = 0.24. But It was observed that M increases according with A and LS, p = 0.030 and p = 0.011, respectively. According with NS, the M presented was: CP with NS 1) 22.5%, NS 2) 19.3%, 3) 21.7%, 4) 54.5%. p = 0.006. The odd of mortality with a 95% confidence interval was: for CP with NS 3 odds ratio (OR) =0.129, p < 0.001, for CP with NS 2 OR= 0.19, p = 0.001 and for CP with NS 1 OR= 0.24, p = 0.006, compared with CP with NS 4. Conclusion: Early parenteral nutrition in addition with enteral nutrition decreases the LS in the ICU and reduces the M in critically ill patients of any age and diagnosis.