The Association between Malnutrition and High Protein Treatment on Outcomes in Critically Ill Patients: A Post Hoc Analysis of the EFFORT Protein Randomized Trial

Chest. 2024 Feb 12:S0012-3692(24)00154-5. doi: 10.1016/j.chest.2024.02.008. Online ahead of print.ABSTRACTBACKGROUND: Pre-existing malnutrition in critically ill patients is associated with adverse clinical outcomes. Malnutrition can be diagnosed with the Global Leadership Initiative on Malnutrition using parameters such as weight loss, muscle wasting and body mass index. International critical care nutrition guidelines recommend high protein treatment to improve clinical outcomes in critically ill patients diagnosed with pre-existing malnutrition. However, this recommendation is based on expert opinion.RESEARCH QUESTIONS: In critically ill patients, what is the association between pre-existing malnutrition and time to discharge alive (TTDA), and does high protein treatment modify this association?STUDY DESIGN AND METHODS: This was a multicenter randomized controlled trial involving 16 countries designed to investigate the effects of high vs. usual protein treatment in 1301 critically ill patients. The primary outcome was TTDA. Multivariable regression was used to identify if pre-existing malnutrition was associated with TTDA, and if protein delivery modified their association.RESULTS: The prevalence of pre-existing malnutrition was 43.8%, and the cumulative incidence of live hospital discharge by day 60 was 41.2% vs. 52.9% in the groups with and without pre-existing malnutrition, respectively. The average protein delivery in the high vs. usual treatment groups was 1.6 vs. 0....
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research