The effect of malnutrition on prognosis in surgical inpatients in the intensive care unit

Abstract

Introduction: Malnutrition, which is a clinical process starting with systemic inflammation and extending to immune deficiency is a common problem in intensive care units. In this study, we aimed to investigate the effect of malnutrition on prognosis in surgical patients followed in intensive care unit. Material and methods: The study is retrospective, and the files of the surgical patients hospitalized in the intensive care units of Aydin State Hospital between January 2018 and January 2020 were reviewed. The demographic data of the patients, the duration of hospitalization in the intensive care unit and the hospital, the type of surgery being urgent-elective, and the ex-discharge status of the patients were recorded. For malnutrition screening, in addition to NRS-2002 and MNA-SF scores at the time of hospitalization, statistical analysis was performed by recording C-reactive protein, albumin, total protein and C-reactive protein/albumin values as markers. Results: A total of 160 patients were included in this study. The mean NRS-2002 score was 2.20±1.85, while the MNA-SF score was 11.39±2.99. The mean C-reactive protein/albumin value was 39.10, the hospital stay in intensive care was 3.4 days, and hospital stay was 13.58 days. It was observed that as the NRS-2002 scores at the time of hospitalization increased and MNA-SF scores decreased, the duration of hospitalization in the intensive care and the hospital increased (p<0.001). However, as the NRS-2002 scores increased and MNA-SF scores decreased, the need for mechanical ventilator and mortality rate increased (p <0.001). Conclusion: Malnutrition is a condition that triggers the inflammatory cascade in surgical patients and has a negative effect on prognosis. Its effect is more pronounced in patients who need intensive care for surgical reasons. We think that the early identification of the risk of malnutrition and providing the necessary nutritional support in the perioperative period, especially in surgical patients who need intensive care, would affect the prognosis positively.