Determining the nutritional status and quality of life of critically ill patients and determining the effectiveness of enteral nutrition therapy

Abstract

Background: Malnutrition is more common in critically ill patients, which is associated with decreased immune status, increased risk of infection, and hospitalization delay. Malnutrition can lead to decreased muscle and tissue mass, decreased mobility and endurance as a result of muscle weakness, slowed immune responses, increased risk of infection, respiratory failure, and other clinical complications, prolonged disease recovery, and further affects mortality. In our country, there is a lack of research and clinical guidelines. Therefore, in practice, the usage of enteral (tube feeding) therapy is low, andon the other hand, there is a need to conduct nutritional research and further increase the use of nutritional therapy in patients with malnutrition. Materials and Methods: The study was a cross-sectional study design. A total of 64 patients in the intensive care unit and critically ill patients undergoing outpatient center gastroenterology at the Mongolia-Japan Hospital of MNUMS were included. Nutritional status was assessed by the ABCD international assessment method and the quality of life of patients was assessed according to the WHOQOL criteria. Patients with malnutrition and those at risk of malnutrition were selected and divided into two groups with no randomization. In the first group, 500 ml of Nutricomp nutrition was administered 2-3 times a day (1300-2340 kcal) depending on the patient’s condition, and in the second group, the treatment diet (average 1000 kcal) was given for 7-10 days each. Assessments were performed before and after treatment. Statistical analyses were performed using the Stata program. Results: Of the participants 45,3% were men, and 54,7% were women. There were 28 (43.7%) cases of malnourished and the risk of malnutrition was 33 (51.68%) and nutritional status was normal 3(4.7%). The quality of life, WHOQOL score mean was 90.71±12.12 (moderate). After treatment, in group I, the mean body weight ranged from 63.51±15.96 kg to 64.33±15.44 kg (p<0.0001), BMI from 23.83±5.33 kg/m2 to 24.14±5.18 kg/m2 (p<0.0001), and waist circumference from 85.53±15.41 cm to 85.82±14.95 cm (p<0.08) respectively increased. Group II weight 68.77±14.92 kg to 68.22±14.69 kg (p<0.0067), BMI 26.00±6.18 kg/m2 to 25.79±6.11 kg/m2 (p<0.0046), waist circumference 89.47±13.25 cm to 88.82±13.24 cm (p<0.0004) respectively decreased. Subcutaneous adipose tissue, wrist circumference, and tibia circumference did not change significantly. After treatment, total group I total protein increased from 66.58±9.98 g/l to 69.00±10.16 g/l (p<0.05), and albumin from 35.40±8.80 g/l to 37.15±7.66 g/l (p<0.05). In group II, total protein from 59.92±9.69 g/l to 56.78±10.02 g/l (p<0.0004) and albumin from 30.86±6.19 g/l to 28.82±5.49 g/l (p<0.0009) respectively decreased. Nutritional status had a statistically significant change in both groups. In group I, which was 17.45±3.54 points before treatment and 19.15±3.36 points after treatment (p<0.0000); group II, was from 16.83±3.55 points to 15.68±3.68 points (p<0.0000). The quality of life, WHOQOL mean score in Group I was 86.53±10.26 points before treatment and 93.07±9.72 points after treatment (p<0.0000); in group II, the score changed from 95.77±10.14 to 93.27±10.78 (p<0.0067). Conclusion: 1. 43.7% of the respondents were malnourishedand 51.6% were at risk of malnutrition, indicating the need for a nutritional treatment in critically ill patients. 2. The guality of life of the respondents is moderate. 3. Anthropometric parameters, clinical signs, nutritional scores, and quality of life increased in group I, decreased in group II (p-value<0.05), albumin increased in group I from laboratory parameters, decreased in group II (p-value<0.05) to evaluate the effectiveness of enteral nutrition before and after treatment.