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Nutritional Assessment of Critically Ill Patients after Abdominal Surgery and Predisposing Factors of Prolonged ICU Stay after Surgery
Surg Metab Nutr 2018;9(2):68-74
Published online December 30, 2018
© 2018 The Korean Society of Surgical Metabolism and Nutrition.

Sung Eun Park, M.D.1, In Kyu Lee, M.D., Ph.D.2, Eun Young Kim, M.D., Ph.D.3

1Department of Surgery, College of Medicine, The Catholic University of Korea, Divisions of 2Colorectal Surgery and 3Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Eun Young Kim, Division of Trauma and Surgical Critical Care, Department of General Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Banpodaero 222, Seocho-gu, Seoul 06591, Korea Tel: +82-2-2258-2876, Fax: +82-2-595-2822, E-mail: freesshs@naver.com
Received October 18, 2018; Accepted November 14, 2018.
This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Patients in prolonged intensive care unit stay were vulnerable to malnutrition which deteriorated recovery and postoperative outcomes. The purpose of this study was to evaluate nutritional status in surgical patients entering the intensive care unit, and to identify the risk factors that influence prolonged intensive care unit stay.
Materials and Methods: From January 2016 to June 2018, 740 patients (age≥18 years) who were admitted to our surgical intensive care unit after abdominal surgery with general anesthesia (≥4 hours) were enrolled. Patients were classified into short-term stay group (≤4 days) and long-term stay group (>4 days). These groups were analyzed and compared with patient factors and postoperative outcomes and the multivariate analysis was performed to assess the risk factors for prolonged intensive care unit stay.
Results: A total of 119 patients were analyzed. The univariate and multivariate analysis showed that dialysis status (Odds ratio 7.684, 95% confidence interval 1.038∼1.103, P=0.013), total lymphocyte count (Odds ratio 0.999, 95% confidence interval 0.998∼1.000, P=0.047), and intraoperative transfusion (Odds ratio 1.002, 95% confidence interval 1.001∼1.002, P=0.000) were associated with prolonged intensive care unit stay. Lone-term stay group were significantly longer hospital stay and higher hospital morbidity rate than short-term stay group.
Conclusion: Patients with risk factors of prolonged intensive care unit stay included dialysis status, low total lymphocyte count, a large amount of transfusion would be more interested and the active intervention such as early nutritional evaluation and adequate nutritional support should be needed.
Keywords : General surgery, Intensive care unit, Nutritional assessment, Risk factor


December 2018, 9 (2)
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