Assessing energy expenditure: Accuracy of predictive equations versus indirect calorimetry in older hospitalized patients at the medical ward.

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-10-01 Epub Date: 2025-07-28 DOI:10.1016/j.clnesp.2025.07.1118

Anne Wilkens Knudsen, Sofie Nunez Engelsted, Cecilia Margareta Lund, Cecilie Meldgaard Møller, Charlotte Suetta, Henrik Højgaard Rasmussen, Tina Munk

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引用次数: 0

Abstract

Background & aims: Indirect calorimetry (IC) is considered the gold standard to measure Resting Energy Expenditure (REE) in clinical practice. However, this method is more time-consuming than using estimates. Therefore, this study aimed to determine 1) the accuracy between estimated and measured energy requirement and 2) if certain patient characteristics were associated with discrepancies between measured and estimated energy requirement.

Methods: The patient's measured REE was assessed with IC. To determine Total Energy Expenditure (TEE), an individual level of activity was applied. The measured REE and TEE were compared with the Harris-Benedict (H-B) equation and measured TEE with two weight-based formulas. A variation of ±10 % was regarded as an acceptable value of variation. To explore whether specific variables were related to differences between measurements and estimates, the following variables were recorded: age, Body Mass Index (BMI), body temperature, heart rate, Mean Arterial Pressure (MAP), respiratory rate, p-C-Reactive Protein (p-CRP), B-Leucocytes, and p-Albumin.

Results: We included 110 patients (58 % women), mean age 81.5 (±7.6) years. The H-B equation most accurately predicted REE for n = 56 (51 %) and TEE for n = 57 (52 %). The H-B equation tended to underestimate REE n = 35 (32 %) rather than overestimate n = 18 (16 %). Underestimation by the H-B equation was significantly (p < 0.05) associated with having higher p-CRP, heart rate, body temperature, and B-Leucocytes. Including these variables with a significant association in a multiple linear regression model revealed that only 17 % (r² = 0.170) of the variation could be explained by these variables.

Conclusion: The H-B equation was most accurate at predicting energy expenditure, however, only in alignment with IC measurements in about half of the patients. Several infectious markers were associated with an increase in REE compared with estimated by the H-B equation.

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评估能量消耗：预测方程与间接量热法在内科病房老年住院患者中的准确性

背景与目的：间接量热法（IC）在临床实践中被认为是测量静息能量消耗（REE）的金标准。然而，这种方法比使用估计更耗时。因此，本研究旨在确定1)估算和测量的能量需求之间的准确性，以及2)某些患者特征是否与测量和估计的能量需求之间的差异有关。方法：用IC评估患者的REE测量值。为了确定总能量消耗（TEE），采用个人活动水平。用Harris-Benedict （H-B）方程和两种基于权重的公式比较了稀土元素和TEE的测量值。±10%的变异被认为是可接受的变异值。为了探讨是否有特定变量与测量值和估计值之间的差异有关，记录了以下变量：年龄、体重指数（BMI）、体温、心率、中动脉压（MAP）、呼吸频率、p- c反应蛋白（p-CRP）、b -白细胞和p-白蛋白。结果：纳入110例患者（58%为女性），平均年龄81.5（±7.6）岁。H-B方程最准确地预测了n=56（51%）和n=57（52%）的REE。H-B方程倾向于低估REE n=35（32%）而不是高估n=18（16%）。H-B方程显著低估（p2=0.170），这些变量可以解释变化。结论：H-B方程在预测能量消耗方面是最准确的，然而，仅与大约一半患者的IC测量结果一致。与H-B方程估计的结果相比，几个感染变量与REE的增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.