Association between nutritional indeces and days of mechanical ventilation in critically ill geriatric patients

Abstract

Summary

Objective: find an association between GNRI and CONUT scores at admission and the presence of prolonged mechanical ventilation in critically ill older adults.

Design and methodology: A cross-sectional, retrospective study was carried out in the Intensive Care Unit "Gastón Segovia Mejía" of the Dalinde Medical Center, between March 2019 and February 2020, all subjects older than 60 years who were selected required mechanical ventilation on admission and for at least 72 hours, patients with a diagnosis of pre-existing lung disease were excluded from the study. Two groups were formed: Group A with less than 7 days of mechanical ventilation, and Group B with more than 7 days. Days of ventilation, demographic and anthropometric variables, admission diagnoses, days of stay in the ICU, service of origin, pre-existing comorbidities were recorded, to determine the severity and mortality in the ICU, the APACHE II, SOFA and risk scales were used GNRI and CONUT to assess nutritional status upon admission.

Results: From the total  of 68 subjects met the inclusion criteria, the mean age of this study was 81 years IQR [72-86], and 51.5% were male, the APACHE II score was 22 IQR [14-26 ] and SOFA 8 IQR [5-9], The median days of stay in the Intensive Care Unit in group A was 8 days and 20 days for the group with more than 7 days of mechanical ventilation, Group A presented a GNRI score of 90 [74-97], while group B had a median of 84 GNRI points [75-93] p 0.432, in contrast to the CONUT scale for group A 8 [6-9] and group B 9 [7-11] p 0.135

Limitations: the type of retrospective study and the number of samples limit the interpretation of the results.

Originality or value of the research: This original study contributes to the knowledge of the evolution of geriatric patients admitted to the Intensive Care Unit who are subjected to mechanical ventilation and its relationship with the degree of malnutrition.

Conclusions: Nutrition is a factor in the evolution and recovery of critically ill geriatric patients, mechanical ventilation is a supportive measure that should be used as such in older adults, although it requires considering the characteristics of the subject, comorbidities and the pathology that led him to require ventilatory mechanical assistance.