The accuracy of estimating equations for total resting energy expenditure in hospitalized patients

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-02-24 DOI:10.1016/j.clnesp.2025.02.009

Mie Kristine Bøgedal Pape , Louise Hyldgaard , Gustav Wedding Stentoft , William Kasper Valbirk , Toke Tinø Toftgård , Ella Ottilia Magdalena Andås , Marianne Køhler , Henrik Højgaard Rasmussen , Sabina Mikkelsen , Mette Holst

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引用次数: 0

Abstract

Background & aims

Methods for estimation of nutritional expenditures for hospitalized patients may not be sufficiently specific. This study aimed to investigate the accuracy of predictive equations compared to indirect calorimetry (IC) and the effect of certain patient characteristics which might correlate with total daily energy expenditure on a heterogeneous population of hospitalized medical patients.

Methods

A cross sectional study including demographic information, measures of bioelectric impedance analysis (BIA) including height and bodyweight (BW), IC, heart rate and from patient records, information was collected regarding nutritional risk by Nutrition Risk Screening 2002, biomarkers of C-reactive protein (CRP), albumin and leukocytes. The Harris-Benedict (HB), Mifflin St. Jeor (MSJ), and Schofield equations were calculated. Data were analyzed using T-test, linear and logistic regression analysis.

Results

Overall, 197 patients, mean age 63.6 ± 16.0 years were measured with IC and had equations performed. BIA was performed in 187 and 46 withdrew, as they were too ill to measure, has oxygen or forgot fasting. All estimation methods underestimate energy expenditures for patients at nutritional risk (p < 0.001), and HB and MSJ underestimate for those with body mass index (BMI) < 18.5 (p = 0.029 and p < 0.001), while for BMI≥30 all overestimate but only HB significantly (p = 0.025). Elevated CRP and leukocytes, lower heart rate, lower and higher BMI, older patients and patients at nutritional risk can affect estimated total daily energy expenditure by equations compared measured by IC (p < 0.05).

Conclusion

HB, MSJ, and Schofield equations all underestimate energy expenditures with higher variations in patients at nutritional risk. In patients with BMI≥30, energy expenditures are overestimated. Considerations are to measure energy expenditures for patients at nutritional risk with continued weight loss and need for artificial nutrition, and for those with BMI≥30.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.