PD225 - ASSOCIATION OF DIETITIAN STAFFING IN ICU WITH NUTRITION PRACTICES: A NUTRITIONDAY DATABASE ANALYSIS

PD225

ASSOCIATION OF DIETITIAN STAFFING IN ICU WITH NUTRITION PRACTICES: A NUTRITIONDAY DATABASE ANALYSIS

V. A. De Araújo^1,*, C. Dupuis², G. Bronne³, J.-C. Preiser³, N. worldwide working group.⁴

¹Federal University of Goiás, Goiânia, Brazil, ²Clermont-Ferrand University Hospital, Clermont-Ferrand, France, ³Erasme University Hospital, Brussels , Belgium, ⁴Medical University of Vienna, Vienna, Austria

Rationale: ICU nutrition care worldwide differs widely. Dietician involvement is not systematic and can influence care. This study aims to document dietician involvement in ICUs globally and its influence on nutrition management.

Methods: Cross-sectional nutritionDay data (2014–2023) were analyzed for ICU adults with length of stay (LOS) ≥48h, including all feeding routes (oral, enteral, parenteral). No adjustment for length-time bias was performed. Variables included dietician availability, severity, and practices. Primary outcomes (caloric goal 80–120% and mortality) were assessed via mixed-effects logistic regression with country as random intercept.

Results: 2.596 patients (47 countries) were available. Dieticians were present in 55.2% (n=1.432) of the ICUs (ICU D+), with regional variations (prevalence >85% Americas/Middle East vs. <45% Europe). Compared to ICUs without a dietician (ICU D-) patients of the ICU D+ were younger (64 [52–73] vs. 66 [54–75] years, p<0.001), less severe (SAPS II (44 [32–58] vs. 45 [34–58], p=0.030), with similar SOFA score (4 [2–7] vs. 4 [2–6], p=0.350). Planned calories were higher in ICU D+ (24 [18.3;28.3] vs. 20.9 [14.3;26.3] kcal/kg, p<0.001) and enteral nutrition more prevalent (67.8% vs. 49.7%, p<0.001). Total calories were similar (19.5 [9;25.7] vs 18.8 [10.6;24.9] kcal/kg, p=0.46), but protein delivered higher in ICU D+ (0.9 [0.4;1.2] vs. 0.8 [0.4; 1.1] g/kg, p=0.030). Goal achievement (80–120%) was higher in ICU D- (77.8%) than ICU D+ (70.9%, p<0.010). Hospital mortality (35.2% vs. 37.4%, p=0.250) and LOS (34 [19–56] vs. 34 [20–55] days, p=0.340) did not differ. In multivariate analysis, dietician presence was not associated with mortality (OR=0.92 [0.73; 1.16]).

Conclusion: ICU dietician presence significantly influences nutrition practices but shows no association with hospital mortality or LOS. 

Disclosure of Interest: None declared