Nutritional status and clinical outcomes in the intensive care unit: A global systematic review and meta-analysis

Abstract

Background

The severity of illness and inability to eat while in the intensive care unit put ICU patients at high risk of malnutrition. Nutritional status assessment is vital for managing patients’ morbidity, length of stay, and mortality. This systematic review aimed to assess the nutritional status of adult ICU patients and evaluate the influence of malnutrition on clinical outcomes.

Methods

A comprehensive systematic review of articles published 2010 to 2024 was conducted Google Scholar, PubMed, Scopus, Web of Science, Cochrane, and Embase included, studies focusing on nutritional status in adult ICU patients. A random-effects meta-analysis model was performed via STATA 17 to determine the overall prevalence of malnutrition among the ICU patients and a forest plot was generated to visually depict the pooled estimate and individual study results. Publication bias was assessed using Egger's test and funnel plots. Heterogeneity was evaluated using I2 and Baujat plots.

Results

This systematic review included prospective and retrospective cohort and cross-sectional studies, 31 publications with a sample size of 21,413 patients. The pooled prevalence of malnutrition was 32.74 (95% confidence interval: 19.9--45.5,I² = 0.0%, τ² = 0.00) and the average length of stay for malnourished patients was 5.6 (2.920, 8.265) days. Malnourished patients had an overall risk of mortality of 1.45 (95% CI: 0.76–2.13).

Conclusion

Malnutrition is prevalent among adult ICU patients, with wide variation across studies, and the situation becomes worse after admission. Additionally, malnourished patients have longer hospital stays and are more likely to die than well-nourished patients.