Evidence map›Paper›PMID 34130034›Full record

ArticleClinical nutrition (Edinburgh, Scotland)2021

Nutritional Risk at intensive care unit admission and outcomes in survivors of critical illness.

Matthew F Mart, Timothy D Girard, Jennifer L Thompson, Hannah Whitten-Vile, Rameela Raman, Pratik P Pandharipande, Daren K Heyland, E Wesley Ely, Nathan E Brummel

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical nutrition (Edinburgh, Scotland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
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  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Matthew F MartDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA.
Timothy D GirardCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA; Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Jennifer L ThompsonDepartment of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
Hannah Whitten-VileCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA.
Rameela RamanCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
Pratik P PandharipandeCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA; Department of Anesthesiology, Division of Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Daren K HeylandClinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada; Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada.
E Wesley ElyDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA; Vanderbilt Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA; VA Tennessee Valley Healthcare System Geriatric Research Education and Clinical Center (GRECC), Nashville, TN, USA; Vanderbilt Center for Quality Aging, Nashville, TN, USA.
Nathan E BrummelCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University College of Medicine, Columbus OH, USA; Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: nathan.brummel@osumc.edu.

Funding

BRAIN-ICU-2 Study: Bringing to Light the Risk Factors And Incidence of Neuropsychological Dysfunction (Dementia) in ICU Survivors, 2nd StudyR01AG058639 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ELY, E WESLEY, JEFFERSON, ANGELA L. · 2019 to 2024
$18.3M
The MIND USA StudyR01AG035117 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ELY, E WESLEY · 2011 to 2016
$7.3M
Clinical and Translational Training Program in Pulmonary MedicineT32HL087738 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Lorraine B Ware · 2007 to 2026
$7.0M
Altering Sedation Paradigms to Improve Brain Injury and Survival in Severe SepsisR01HL111111 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PANDHARIPANDE, PRATIK · 2012 to 2017
$3.7M
The MIND ICU StudyR01AG027472 · NIA · VANDERBILT UNIVERSITY · PI ELY, E WESLEY · 2006 to 2010
$3.0M
The INSIGHT-ICU Study: Illuminating Neuropsychological dysfunction and Systemic Inflammatory mechanisms Gleaned after Hospitalization in Trauma-ICU StudyR01GM120484 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PATEL, MAYUR B · 2017 to 2021
$3.0M
Mitochondrial Determinants of Cognitive Outcomes in ARDS and Sepsis - SupplementR01HL135144 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI GIRARD, TIMOTHY D · 2017 to 2021
$2.2M
Long Term Outcomes of Physical Activity in Older Adults with Critical IllnessK76AG054864 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BRUMMEL, NATHAN E · 2016 to 2020
$826k
NHLBI NIH HHS R01 HL111111NHLBI NIH HHS R01 HL135144NHLBI NIH HHS T32 HL087738NIA NIH HHS K76 AG054864NIA NIH HHS L30 AG048581NIA NIH HHS R01 AG027472NIA NIH HHS R01 AG035117NIA NIH HHS R01 AG058639NIGMS NIH HHS R01 GM120484
6 · The paper itself

Abstract

BACKGROUND AND

aimsRisk factors for poor outcomes after critical illness are incompletely understood. While nutritional risk is associated with mortality in critically ill patients, its association with disability, cognitive, and health-related quality of life is unclear in survivors of critical illness. This study's objective was to determine whether greater nutritional risk at ICU admission is associated with greater disability, worse cognition, and worse HRQOL at 3 and 12-month follow-up.

methodsWe enrolled adults (≥18 years of age) with respiratory failure or shock treated in medical and surgical intensive care units from two U.S. centers. We measured nutritional risk using the modified Nutrition Risk in Critically Ill (mNUTRIC) score (range 0-9 [highest risk]) at intensive care unit admission. We measured associations between mNUTRIC scores and discharge destination, disability in basic activities of daily living (ADLs) using the Katz ADL, instrumental ADLs using the Functional Activities Questionnaire (FAQ), global cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), executive function using the Trail Making Test Part B (Trails B), and health-related quality of life using the SF-36, adjusting for sex, education, BMI, baseline frailty, disability, and cognition, severity of illness, days of delirium, coma, and mechanical ventilation.

resultsOf the 821 patients enrolled in the ICU, 636 patients survived to hospital discharge. We assessed outcomes in 448 of 535 survivors (84%) at 3 months and 382 of 476 survivors (80%) at 12 months. Higher mNUTRIC scores predicted greater odds of discharge to an institution (OR 2.0, 95% CI: 1.6 to 2.6; P < 0.01). Higher mNUTRIC scores were associated with a trend towards greater disability in basic activities of daily living (IRR 1.3, 95% CI 1.0 to 1.7) at 3 months that did not reach significance (p = 0.09) with no association demonstrated at 12 months. There were no associations between mNUTRIC scores and FAQ, RBANS, or Trails B scores. mNUTRIC scores were inconsistently associated with SF-36 physical and mental component scale scores.

conclusionsGreater nutritional risk at ICU admission is associated with disability in survivors of critical illness. Future studies should evaluate interventions in those at high nutritional risk as a means to speed recovery.

Indexed as

Patient AdmissionAgedCritical IllnessFemaleHumansIntensive Care UnitsMaleMalnutritionMiddle AgedNutritional StatusQuality of LifeRisk FactorsSeverity of Illness IndexUnited StatesActivities of daily livingCognitive dysfunctionCritical illnessNutrition assessmentPatient dischargeQuality of life

Identifiers

PMID34130034
PMCPMC8243837

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.