Agreement Evaluation of Energy Expenditure Estimations by Predictive Equation and Indirect Calorimetry in Critically Ill Neurosurgical Patients.

Abstract

The primary aim of this study was to evaluate the value of predictive equation (PE) standard care compared with indirect calorimetry (IC)-based nutrition therapy. The secondary aim was to compare the results among 3 groups to assess the accuracy of IC and PE. This was a single-center, retrospective study of patients admitted to the neurosurgery (NS) intensive care unit (ICU), from January 2019, to August 2020. Anthropometric, biochemical, clinical, and dietary data were collected from NS ICU admission to discharge. If patients had an IC: PE ratio of 90%-110%, they were classified into the optimal estimation group (OEG); if the ratio was < 90%, they were classified into the underestimation group (UG); and if the ratio was > 110%, they were classified into the overestimation group (OG). There were no significant differences in anthropometric, biochemical, clinical data and nutrition assessment between baseline and discharge from the NS ICU. The OEG showed a larger cumulative caloric deficit rate compared to UG and OG, though this difference was not statistically significant. There was a negative association between calf circumference (CC) and length of stay (LOS). Repeated measures of CC showed a significant difference according to LOS and groups (p < 0.001). Anthropometric, biochemical, clinical, and dietary data of 77 NS patients were analyzed to determine the effectiveness of concordance between IC and PE. The UG and OG showed a significant decrease in CC during hospitalization, but CC in the OEG was maintained or increased from 4 weeks onward.

Trial registration: Clinical Research Information Service Identifier: KCT0006381.