Shir Lynn Lim, Ryan Ruiyang Ling, Oliver Lim, Ryo Ueno, Daryl Jones, Christopher Low, Marcus E H Ong, Emma J Ridley, Krishnaswamy Sundararajan, David Pilcher, Kollengode Ramanathan, Ashwin Subramaniam
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引用次数: 0
Abstract
Background: The double burden of malnutrition, defined as the co-existence of overnutrition with undernutrition, is increasing in prevalence globally. Yet, little is known about its impact on patients with cardiac arrest. We examined the association between malnutrition and outcomes in patients admitted to intensive care units (ICU) after cardiac arrest.
Methods: In this retrospective cohort study, we included adults admitted to ICU in Australia or New Zealand between 1/1/2018 through 31/3/2023 who had suffered a cardiac arrest in the 24 h prior to admission. We categorized patients based on the presence of obesity (BMI ≥ 30 kg/m2) and nutrition risk (using the modified Nutrition Risk in Critically ill score ≥5) and investigated the association between obesity and high nutrition risk with survival time up to 1 year, adjusting for a prespecified list of covariates. We also analysed this association in specific subgroups (age <65 years vs ≥65 years, location of arrest, frailty status, sex, and in patients who survived their initial hospitalisation).
Results: We included 12,565 patients with a median age of 62.4 (IQR: 49.4-72.8) years and 8426 (67.1 %) males; 4088 (32.5 %) were neither obese nor at high nutrition risk, 2170 (17.3 %) had obesity, 4001 (31.8 %) had high nutrition risk, and 2306 (18.4 %) were both obese and high nutrition risk. Compared to patients with neither obesity nor high nutrition risk, obesity combined with high nutrition risk (HR: 1.61, 95 %-CI: 1.40-1.85) and high nutrition risk alone (HR: 1.66, 95 %-CI: 1.47-1.87) were associated with reductions in survival time. However, obesity alone (HR: 0.93, 95 %-CI: 0.83-1.03) was not associated with a significant difference in survival time. These results were consistent across subgroups.
Conclusion: Among resuscitated cardiac arrest patients admitted to ICU, high nutrition risk is prevalent regardless of obesity status and is associated with poorer outcomes in-hospital and up to one year. More research is needed to identify mitigating strategies for malnourished patients.
期刊介绍：
Resuscitation is a monthly international and interdisciplinary medical journal. The papers published deal with the aetiology, pathophysiology and prevention of cardiac arrest, resuscitation training, clinical resuscitation, and experimental resuscitation research, although papers relating to animal studies will be published only if they are of exceptional interest and related directly to clinical cardiopulmonary resuscitation. Papers relating to trauma are published occasionally but the majority of these concern traumatic cardiac arrest.
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