The Interplay of Nutrition, Physical Activity, Severity of Illness, and Mortality in Critically Ill Burn Patients: Is There a Connection?

The Interplay of Nutrition, Physical Activity, Severity of Illness, and Mortality in Critically Ill Burn Patients: Is There a Connection?

Abstract The purpose of this project was to evaluate the relationships between nutrition, physical activity levels (PALs), severity of illness (SOI), and survival in critically ill burn patients. We conducted a retrospective evaluation of consecutively admitted adult patients who had an intensive ca...

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Bibliographic Details
Published in:Journal of burn care & research Vol. 40; no. 6; pp. 936 - 942
Main Authors: Shields, Beth A, Carpenter, Jennifer N, Bustillos, Brenda D, Jordan, Alicia N, Cunningham, Kyle B, Vega, Saul J, Aden, James K, Rowan, Matthew P, Rizzo, Julie A, Dewey, William S, Gurney, Jennifer M, Ainsworth, Craig R, Cancio, Leopoldo C
Format: Journal Article
Language:English
Published: US Oxford University Press 16-10-2019
Subjects:
Adult
Aged
Body Height
Burns - mortality
Critical Illness - mortality
Eating
Exercise
Female
Humans
Intensive Care Units
Male
Middle Aged
Nutritional Status
Nutritional Support
Organ Dysfunction Scores
Retrospective Studies
Severity of Illness Index
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Summary:Abstract The purpose of this project was to evaluate the relationships between nutrition, physical activity levels (PALs), severity of illness (SOI), and survival in critically ill burn patients. We conducted a retrospective evaluation of consecutively admitted adult patients who had an intensive care unit stay ≥8 days after ≥20% TBSA burns. Linear regression was used to assess the association between SOI (sequential organ failure assessment scores) and PALs as well as between SOI and nutritional intake. After univariate analysis comparing survivors and nonsurvivors, factors with P < .10 were analyzed with multiple logistic regression. Characteristics of the 45 included patients were: 42 ± 15 years old, 37 ± 17% TBSA burns, 22% mortality. Factors independently associated with survival were burn size (negatively) (P = .018), height (positively) (P = .006), highest PAL during the first eight intensive care unit days (positively) (P = .016), and kcal balance during the fifth through the eighth intensive care unit days (positively) (P = .012). Sequential organ failure assessment scores had a significant (P < .001) but weak association with nutrition intake (R2 = 0.05) and PALs (R2 = 0.25). Higher nutritional intake and activity were significantly associated with lower mortality in critically ill burn patients. Given the weak associations between both nutritional intake and PALs with SOI, the primary barrier in achieving nutrition and activity goals was not SOI. We recommend that physical rehabilitation and nutritional intake be optimized in an effort to improve outcomes in critically ill burn patients.
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ISSN:1559-047X
1559-0488
DOI:10.1093/jbcr/irz126