P400 - SUBOPTIMAL NUTRITION DELIVERY IN CRITICALLY ILL PATIENTS: IMPLICATIONS FOR MORTALITY RISK AND THE TIMING OF NUTRITIONAL INTERVENTIONS

P400

SUBOPTIMAL NUTRITION DELIVERY IN CRITICALLY ILL PATIENTS: IMPLICATIONS FOR MORTALITY RISK AND THE TIMING OF NUTRITIONAL INTERVENTIONS

S. Pouriki¹, A. Andrianopoulos¹, T. E. Sialvera², D. Karayiannis^3,*, A. Raftopoulou³, Z. Mastora¹

¹ Intensive Care Medicine, Center for Respiratory Failure, ²Department of Clinical Nutrition and Dietetics, Sotiria" General Hospital of Chest Diseases, ³Department of Clinical Nutrition and Dietetics, Evaggelismos General Hospital, Athens, Greece

Rationale: Adequate nutrition is crucial in the Intensive Care Unit (ICU) to improve outcomes. This study investigates the degree of nutrition adequacy achieved in critically ill patients and its potential implications.

Methods: We prospectively analyzed data from 34 adult patients (mean age 65.8 ± 13.9 years) admitted to our ICU. Malnutrition rate was 38.8%, and the median mNUTRIC score was 3.4 ± 2.14. Data on prescribed versus actual calorie and protein intake during their ICU stay were collected. Nutrition adequacy was defined as the percentage of prescribed calories and protein received. Primary end point was 30 day mortality.

Results: Nutrition intake significantly deviated from requirements for energy (p < 0.001) and protein (p < 0.001). Patients received 66.2 ± 25.6% of prescribed calories and 61.5 ± 31.2% of prescribed protein, highlighting a substantial delivery gap. Notably, after adjusting for confounders (age, gender, mNutricScore, major comorbidities) late-phase nutrition adequacy (days 7–14) was associated with reduced 30-day mortality risk, with hazard ratios of 0.921 (95% CI: 0.897–0.954) for energy and 0.954 (95% CI: 0.916–0.992) for protein. No such associations were observed in the early phase (days 1–7). 

Conclusion: These findings underscore a critical shortfall in achieving nutrition adequacy, which may elevate mortality risk, particularly during the late acute phase. Optimizing nutrition delivery requires strategies such as minimizing feeding interruptions, protocolized feeding, and individualized monitoring. Future research should prioritize interventions targeting the late phase (days 7–14) to improve clinical outcomes

Disclosure of Interest: None declared