The impact of the early enteric nutrition up to scratch on the prognosis of critical care patients with different severities of illness.

Abstract

Objective To determine the effects of the early enteric nutrition （EEN） up to scratch on the outcomes of the critical care patients with different degrees of severity of illness. Method There were 192 critically ill patients eligible for enrollment for study during the past 18 months in our ICU. They were classified by using APACHE Ⅱ scores. The aim of this retrospective analysis of the early enteric nutrition was to see if the enteric nufore, the patients were divided into two groups： up to scratch group and not up to scratch group. According to APACHE Ⅱ scores, the patients of each group were further divided into three sub-groups in terms of scores below 15, between15 and 25, and above 25, respectively. Results There were 62 patients in the group of EEN up to scratch, and 130 patients＇ EEN did not up to scratch. When the scores of APACHE Ⅱ were below 15, the length of hospital stay （LOS） was significantly shorter in group of EEN up to scratch in comparison with that of EEN not up to scratch （t = 6.453, P = 0.000）. When the scores of APACHE Ⅱ were between15 and 25, the LOS in ICU （t = 3.966, P = 0.000）, in hospital （t = 8.165,P = 0.000）, The cost of medical care （t = 4.812,P= 0.000） and the mortality （x2 = 5.421,P = 0.038） were all significantly less in patients with EEN up to scratch. However, when the scores of APACHE Ⅱ were above 25, only the cost of medical care （ t = 7.364, P = 0.000） was significantly lower in patients of EEN up to scratch than that of EEN not up to scratch. Conclusions The EEN up to scratch can significantly improve the outcomes of critical patients and the clinical value of EEN up to scratch depends on the severity of illness. Key words: Early enteral nutrition; Critical care; Severity of illness; Death risk; Prognosis