TY - JOUR
T1 - Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia
T2 - A multicentre prospective observational study
AU - Ridley, Emma J.
AU - Chapple, Lee anne S.
AU - Ainscough, Kate
AU - Burrell, Aidan
AU - Campbell, Lewis
AU - Dux, Claire
AU - Ferrie, Suzie
AU - Fetterplace, Kate
AU - Jamei, Matin
AU - King, Victoria
AU - Neto, Ary Serpa
AU - Nichol, Alistair
AU - Osland, Emma
AU - Paul, Eldho
AU - Summers, Matthew
AU - Marshall, Andrea P.
AU - Udy, Andrew
N1 - Funding Information:
We would like to thank the Australia and New Zealand Intensive Care Research Centre (ANZIC-RC) as the coordinating centre and Rhea Louis for assisting with the REDCap database build. We would like to thank Melanie Blair who was associated with Royal Darwin Hospital during the study period and all participating sites for their contribution to data during a challenging period of time and in the absence of financial support.
Publisher Copyright:
© 2023
PY - 2023/11
Y1 - 2023/11
N2 - Background: The COVID-19 pandemic highlighted major challenges with usual nutrition care processes, leading to reports of malnutrition and nutrition-related issues in these patients. Objective: The objective of this study was to describe nutrition-related service delivery practices across hospitalisation in critically ill patients with COVID-19 admitted to Australian intensive care units (ICUs) in the initial pandemic phase. Methods: This was a multicentre (nine site) observational study in Australia, linked with a national registry of critically ill patients with COVID-19. Adult patients with COVID-19 who were discharged to an acute ward following ICU admission were included over a 12-month period. Data are presented as n (%), median (interquartile range [IQR]), and odds ratio (OR [95% confidence interval {CI}]). Results: A total of 103 patients were included. Oral nutrition was the most common mode of nutrition (93 [93%]). In the ICU, there were 53 (52%) patients seen by a dietitian (median 4 [2–8] occasions) and malnutrition screening occurred in 51 (50%) patients most commonly with the malnutrition screening tool (50 [98%]). The odds of receiving a higher malnutrition screening tool score increased by 36% for every screening in the ICU (1st to 4th, OR: 1.39 [95% CI: 1.05–1.77] p = 0.018) (indicating increasing risk of malnutrition). On the ward, 51 (50.5%) patients were seen by a dietitian (median time to consult: 44 [22.5–75] hours post ICU discharge). The odds of dietetic consult increased by 39% every week while on the ward (OR: 1.39 [1.03–1.89], p = 0.034). Patients who received mechanical ventilation (MV) were more likely to receive dietetic input than those who never received MV. Conclusions: During the initial phases of the COVID-19 pandemic in Australia, approximately half of the patients included were seen by a dietitian. An increased number of malnutrition screens were associated with a higher risk score in the ICU and likelihood of dietetic consult increased if patients received MV and as length of ward stay increased.
AB - Background: The COVID-19 pandemic highlighted major challenges with usual nutrition care processes, leading to reports of malnutrition and nutrition-related issues in these patients. Objective: The objective of this study was to describe nutrition-related service delivery practices across hospitalisation in critically ill patients with COVID-19 admitted to Australian intensive care units (ICUs) in the initial pandemic phase. Methods: This was a multicentre (nine site) observational study in Australia, linked with a national registry of critically ill patients with COVID-19. Adult patients with COVID-19 who were discharged to an acute ward following ICU admission were included over a 12-month period. Data are presented as n (%), median (interquartile range [IQR]), and odds ratio (OR [95% confidence interval {CI}]). Results: A total of 103 patients were included. Oral nutrition was the most common mode of nutrition (93 [93%]). In the ICU, there were 53 (52%) patients seen by a dietitian (median 4 [2–8] occasions) and malnutrition screening occurred in 51 (50%) patients most commonly with the malnutrition screening tool (50 [98%]). The odds of receiving a higher malnutrition screening tool score increased by 36% for every screening in the ICU (1st to 4th, OR: 1.39 [95% CI: 1.05–1.77] p = 0.018) (indicating increasing risk of malnutrition). On the ward, 51 (50.5%) patients were seen by a dietitian (median time to consult: 44 [22.5–75] hours post ICU discharge). The odds of dietetic consult increased by 39% every week while on the ward (OR: 1.39 [1.03–1.89], p = 0.034). Patients who received mechanical ventilation (MV) were more likely to receive dietetic input than those who never received MV. Conclusions: During the initial phases of the COVID-19 pandemic in Australia, approximately half of the patients included were seen by a dietitian. An increased number of malnutrition screens were associated with a higher risk score in the ICU and likelihood of dietetic consult increased if patients received MV and as length of ward stay increased.
KW - COVID-19
KW - Critical illness
KW - Intensive care
KW - Malnutrition
KW - Nutrition
UR - http://www.scopus.com/inward/record.url?scp=85148337256&partnerID=8YFLogxK
U2 - 10.1016/j.aucc.2023.01.003
DO - 10.1016/j.aucc.2023.01.003
M3 - Article
C2 - 36806392
AN - SCOPUS:85148337256
SN - 1036-7314
VL - 36
SP - 955
EP - 960
JO - Australian Critical Care
JF - Australian Critical Care
IS - 6
ER -
