The assessment of the malnutrition in traumatic ICU patients in Iran

BACKGROUND Despite recognition of the importance of nutritional feedings, the delivery of optimal nutrition remains difficult to achieve in most intensive care units (ICU). OBJECTIVE To assess the status of malnutrition in traumatically ill patients hospitalized in an ICU in Iran. METHODS This descriptive, cross-sectional study was conducted in Hamadan, Iran, on 123 patients in an ICU ward over six months with the purpose of assessing malnutrition status. Malnutrition and its severity were assessed based on the defined chemical parameters on admission and the end of stay times. Also, body mass index (BMI), weight (W), and height (H) anthropometric indices were assessed simultaneously to be compared with the chemical results. For statistical analysis we used SPSS version 16 software. RESULTS Overall, 83% of patients had malnutrition on admission to ICU, which was 90% on discharge or near-death condition, indicating increase of the prevalence of malnutrition within hospitalization in this ward. On admission, 11% of patients had mild, 61% moderate, and 11% severe malnutrition that reached to 4%, 63%, and 23%, respectively, by the end of the stay. BMI was significantly different in the patients who completed two weeks in the ICU (p<0.05). Assessment of the correlation between admission and two week completed stay showed that BMI, H, and W were positively correlated (r=0.85), (r=1.0), and (r=0.638), (p<0.05), respectively. There were no significant correlations in these parameters in the fourth week. Assessing the changes in anthropometric parameters showed downward trends of both weight and body mass index within ICU hospitalization. CONCLUSION As shown in our study, inattention to needs of critically ill patients or lack of facilities results in developing and worsening of malnutrition, which, in turn, considerably worsens the outcome. To supply the needs of these in-hypermetabolic state patients, the importance of nutrition and its effect on outcome must be understood by medical staff; close monitoring of the nutritional status of these patients, along with meticulous calculations and team work, must be done and appropriate supportive routs be used.