ArticleFrontiers in nutrition2026
Analysis of the predictive value of 3-day cumulative energy deficit for 28-day mortality in patients with sepsis and nutritional risk: a retrospective study.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Cumulative energy deficit in the early phase of critical illness is associated with increased mortality and worsened clinical outcomes. To identify early risk factors for 28-day mortality in patients with sepsis combined with nutritional risk to inform early clinical recognition and intervention. Methods: A retrospective analysis of clinical data from sepsis patients in the ICU at the Affiliated Hospital of Inner Mongolia Medical University was conducted from January 2022 to January 2025 (ethics approval: KY2025177). Patients were categorized as survivors or non-survivors based on 28-day outcomes. Nutritional risk was defined as NRS-2002 score ≥ 3. Sepsis was diagnosed according to Sepsis-3.0 criteria. The 3-day cumulative energy deficit was calculated as the difference between target energy requirement (estimated using Harris-Benedict formula with 25 kcal/kg coefficient) and actual energy intake (enteral, parenteral, and oral) over the first 3 days of ICU admission. Risk factors were identified through univariate and multivariate logistic regression, and their predictive effectiveness was evaluated using ROC curves. Subgroup analyses employed optimal cutoff values. Results: Among 516 eligible patients, 360 were analyzed (305 survivors and 55 non-survivors). The median age was 70 years (IQR 58.0-77.0) in the survival group and 74 years (IQR 62.0-85.0) in the death group ( Conclusion: This study identified age and 3-day cumulative energy deficit as early independent predictors of 28-day mortality in septic patients with nutritional risk. A cumulative energy deficit threshold of ≥2,916 kcal over 3 days demonstrated discriminative value for risk stratification. These findings underscore the prognostic significance of early energy balance monitoring in this high-risk population and may inform the design of future interventional studies targeting nutritional optimization.
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