Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study): Does nutrition really affect ICU mortality?

• Published in: Clinical nutrition ESPEN 2022-02, Vol.47, p.325-332
• Main Authors: Lopez-Delgado, Juan C., Bordeje-Laguna, M Luisa, Mor-Marco, Esther, Lorencio-Cardenas, Carol, Vera-Artazcoz, Paula, Iglesias-Rodriguez, Rayden, Flordelis-Lasierra, José L., Menor-Fernández, Eva M., Servia-Goixart, Lluís, Trujillano-Cabello, Javier, Escobar-Ortiz, Joan, Montserrat-Ortiz, Neus, Zapata-Rojas, Amalia, Grau-Carmona, Teodoro, Bautista-Redondo, Iris, Diaz-Castellanos, Laura, Bono, Montserrat Plaza, Montejo-Gonzalez, Juan Carlos, Temprano-Vazquez, Susana, Arjona-Diaz, Veronica, Mudarra-Reche, Carolina, Orejana-Martin, Maria, Lopez-Delgado, Juan Carlos, Lores-Obradors, Africa, Anguela-Calvet, Laura, Muñoz-Del Río, Gloria, Revelo-Esquibel, Pamela Alejandra, Luna-Solis, Stephani Maria, Salinas-Canovas, Alvaro, De Frutos-Seminario, Fernando, Rodriguez-Queralto, Oriol, Zamora-Elson, Monica, Fuente-O'Connor, Eugenia de la, Arbeloa, Carlos Seron, Bueno-Vidales, Nestor, Martin-Luengo, Ana, Sanchez-Miralles, Angel, Marmol-Peis, Enrique, Ruiz-Miralles, Miriam, Gonzalez-Sanz, Maria, Server-Martinez, Arantzazu, Vila-Garcia, Belen, Macaya-Redin, Laura, Aldunate-Calvo, Sara, Flordelis-Lasierra, Jose Luis, Rio, Irene Jimenez-del, Rodriguez-Roldan, Jose Manuel, Gastaldo-Simeon, Rosa, Fernandez-Ortega, Juan Francisco, Martinez-Carmona, Juan F., Lopez-Luque, Esther, Crespo-Gomez, Monica, Lopez-García, Esther, Navarro-Lacalle, Arturo, Martinez-Garcia, Pilar, Dominguez-Fernandez, Maria Inmaculada, Izura-Gomez, Marta, Hernandez-Duran, Susana, Rovira-Valles, Yaiza, Philibert, Viridiana, Alcazar-Espin, Maravillas de las Nieves, Calvo-Herranz, Enrique, Manzano-Moratinos, Diego, Portugal-Rodriguez, Esther, Andaluz-Ojeda, David, Parra-Morais, Laura, Citores-Gonzalez, Rafael, Sanchez-Giron, Gloria Renedo, Navas-Moya, Elisabeth, Ferrer-Pereto, Carles, Lluch-Candal, Cristina, Leon-Cinto, Cristina, Yebenes-Reyes, Juan Carlos, Nieto-Martino, Beatriz, Vaquerizo-Alonso, Clara, Almanza-Lopez, Susana, Anton-Pascual, Jose Luis, Marin-Corral, Judith, Sistachs-Baquedano, Maite, Hacer-Puig, Maria, Picornell-Noguera, Marina, Mateu-Campos, Lidon, Martinez-Valero, Clara, Llorente-Ruiz, Beatriz, Martinez-Diaz, María Cristina, Fernandez-Salvatierra, Leticia, Millan-Taratiel, Paula, Tejada-Artigas, Antonio, Martinez-Arroyo, Ines, Araujo-Aguilar, Pilar, Fuster-Cabre, Maria, Touceda-Bravo, Alberto, Almorin-Gonzalvez, Laura, Gero-Escapa, Maria, Martinez-Barrio, Esther, Monge-Donaire, Diana
• Format: Article
• Language: English
• Subjects: Adult; adults; clinical nutrition; Critical Care; disease severity; enteral feeding; Enteral Nutrition; hemodialysis; Humans; Intensive care unit; Intensive Care Units; Mortality; multivariate analysis; nutrition risk assessment; Nutritional Status; Nutritional therapy; observational studies; parenteral feeding; Parenteral Nutrition; patients; protein intake; risk
• ISSN: 2405-4577; 2405-4577
• DOI: 10.1016/j.clnesp.2021.11.018

The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients. This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported. We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P