Mortality and Duration of Intensive Care Unit

There is limited evidence for the association between malnutrition and hospital mortality 18 as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to 19 examine the aforementioned associations by conducting a prospective cohort study in an ICU of a 20 Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥24 h of 21 ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to 22 determine patients’ nutritional status within 48 h of ICU admission. Multivariate analyses were 23 conducted in two ways: 1) presence versus absence of malnutrition, and 2) dose-dependent 24 association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% 25 were malnourished, and 29.6% died before hospital discharge. Malnutrition was associated with an 26 increased risk of hospital mortality [adjusted-RR 1.39 (95%CI: 1.10–1.76)], and this risk increased 27 with a greater degree of malnutrition [adjusted-RR 1.09 (95%CI: 1.01–1.18) for each 1-point 28 decrease in the 7-point SGA]. No significant association was found between malnutrition and 29 ICU-LOS. Conclusion: There was a clear association between malnutrition and higher hospital 30 mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be 31 replicated and hence requires further evaluation. 32