Evidence map›Paper›PMID 41097257›Full record

Observational studyNutrients2025

Nutritional Adequacy and Day-to-Day Energy Variability: Impacts on Outcomes in Severe Trauma Patients.

Jovana Stanisavljevic, Nikola N Grubor, Sergej Marjanovic, Ivan Palibrk, Mihailo Bezmarevic, Jelena Velickovic, Adi Hadzibegovic, Marija Milenkovic, Sanja Ratkovic, Bojan Jovanovic

Abstract readObservational Study
In one paragraph

Observational study in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

10 authors.

Jovana StanisavljevicDepartment of Anesthesiology, Emergency Center, University Clinical Center of Serbia, 11000 Belgrade, Serbia.ORCID 0000-0002-7230-0112
Nikola N GruborInstitute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.ORCID 0009-0007-7876-1554
Sergej MarjanovicFaculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.ORCID 0009-0004-0826-186X
Ivan PalibrkFaculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.ORCID 0000-0002-5019-2886
Mihailo BezmarevicDepartment of Hepatobiliary and Pancreatic Surgery, Clinic for General Surgery, Military Medical Academy, University of Defense, 11042 Belgrade, Serbia.ORCID 0000-0003-1938-8298
Jelena VelickovicFaculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Adi HadzibegovicDepartment of Anesthesiology, Emergency Center, University Clinical Center of Serbia, 11000 Belgrade, Serbia.ORCID 0000-0003-4956-3093
Marija MilenkovicDepartment of Anesthesiology, Emergency Center, University Clinical Center of Serbia, 11000 Belgrade, Serbia.ORCID 0000-0002-3275-2288
Sanja RatkovicDepartment of Anesthesiology, Emergency Center, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Bojan JovanovicDepartment of Anesthesiology, Emergency Center, University Clinical Center of Serbia, 11000 Belgrade, Serbia.ORCID 0000-0002-8699-6456

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOptimal energy and protein delivery during the early phase of severe trauma remains unclear. Observational studies frequently contradict the findings of randomized controlled trials, raising concerns about confounding factors. The aim of this study is to assess nutritional adequacy and daily variability in the energy gaps and its impact on outcomes using innovative statistical methods.

methodsProspective observational study enrolled severely injured patients in the ICU at the Level 1 trauma center between October 2023 to April 2025. To describe the evolution of calorie and protein deficits during the first 10-day ICU stay, we utilized a linear mixed-effects model to estimate each patient's individual energy gap trajectory.

results286 patients were analyzed. Median APACHE II and ISS score was 16.0 (12.0-20.0) and 22.0 (18.0-27.0), respectively. Mortality rate was 35.3%. Patients received 68.3% of prescribed calories and 76.8% of proteins. Admission energy deficit, rate of caloric intake, and their interaction are associated with ICU mortality. Increased day-to-day energy variability was associated with longer duration of mechanical ventilation (HR = 0.55, 95% CI: 0.31-0.99;

conclusionsThis study supports the 2023 ESPEN guidelines, showing that achieving the recommended energy and protein intake during the early phase of severe trauma is linked to lower mortality rates, shorter mechanical ventilation time, and reduced risk of nosocomial infections.

Indexed as

Energy IntakeNutritional StatusWounds and InjuriesAdultAPACHEDietary ProteinsFemaleHospital MortalityHumansIntensive Care UnitsLength of StayMaleMiddle AgedProspective StudiesRespiration, ArtificialTrauma CentersDietary Proteinscaloric adequacyclinical nutritionICUoutcomesprotein adequacysevere trauma

Identifiers

PMID41097257
PMCPMC12525652

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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.