Combined Effect of the Timing of Initiation of Nutrition and Nutrition Risk on Outcomes in a Mixed Intensive Care Unit of a Tertiary Hospital in a Middle-income Country.

Background: The importance of nutrition in the critically ill is well known but its practice is varied globally. Determining the nutrition risk is important to help improve outcomes. Materials and methods: A prospective observational study involved patients admitted to the intensive care unit (ICU) who stayed for at least 48 hours. The demographics of participants modified the NUTRIC score, and comorbidities were assessed. The timing of nutrition initiation was noted to get two main cohorts: Early (within 48 hours of admission) and delayed (after 48 hours of admission). All the patients were followed for a maximum of 30 days in the hospital to determine outcome variables such as mortality and length of hospital stay. The ICU-free days (30 minus days in ICU) and 30-day hospital-free days were calculated and recorded for each patient. Results: A total of 489 patients, 59.9% were males, 75.5% were mechanically ventilated and total parenteral nutrition utilization was 13.2%. The prevalence of nutrition risk was 21.1%. The patients who had early nutrition constituted 36.6%. There was no difference in the primary outcome of ICU-free days between the two groups; 24 (19-25.5) and 24 (16-25) days, respectively; Conclusion: The timing of the initiation of nutrition does not affect ICU-free days and 30-day hospital-free days irrespective of the nutrition risk on admission. A high modified NUTRIC score is associated with reduced ICU-free days and 30-day hospital-free days and increased mortality. How to cite this article: Siaw-Frimpong M, Korula PJ, Karuppusami R, Gyapon NF, Subramani K, Chander RU,