Ridley, Emma J

Chapple, Lee-Anne S

Ainscough, Kate

Burrell, Aidan

Campbell, Lewis

Dux, Claire

Ferrie, Suzie

Fetterplace, Kate

Jamei, Matin

King, Victoria

Neto, Ary Serpa

Nichol, Alistair

Osland, Emma

Paul, Eldho

Summers, Matthew

Marshall, Andrea P

Udy, Andrew

2023-11-01

BACKGROUND: The COVID-19 pandemic highlighted major challenges with usual nutrition care processes, leading to reports of malnutrition and nutrition-related issues in these patients. OBJECTIVE: The objective of this study was to describe nutrition-related service delivery practices across hospitalisation in critically ill patients with COVID-19 admitted to Australian intensive care units (ICUs) in the initial pandemic phase. METHODS: This was a multicentre (nine site) observational study in Australia, linked with a national registry of critically ill patients with COVID-19. Adult patients with COVID-19 who were discharged to an acute ward following ICU admission were included over a 12-month period. Data are presented as n (%), median (interquartile range [IQR]), and odds ratio (OR [95% confidence interval {CI}]). RESULTS: A total of 103 patients were included. Oral nutrition was the most common mode of nutrition (93 [93%]). In the ICU, there were 53 (52%) patients seen by a dietitian (median 4 [2-8] occasions) and malnutrition screening occurred in 51 (50%) patients most commonly with the malnutrition screening tool (50 [98%]). The odds of receiving a higher malnutrition screening tool score increased by 36% for every screening in the ICU (1st to 4th, OR: 1.39 [95% CI: 1.05-1.77] p = 0.018) (indicating increasing risk of malnutrition). On the ward, 51 (50.5%) patients were seen by a dietitian (median time to consult: 44 [22.5-75] hours post ICU discharge). The odds of dietetic consult increased by 39% every week while on the ward (OR: 1.39 [1.03-1.89], p = 0.034). Patients who received mechanical ventilation (MV) were more likely to receive dietetic input than those who never received MV. CONCLUSIONS: During the initial phases of the COVID-19 pandemic in Australia, approximately half of the patients included were seen by a dietitian. An increased number of malnutrition screens were associated with a higher risk score in the ICU and likelihood of dietetic consult increased if patients received MV and as length of ward stay increased.

The Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia. Electronic address: emma.ridley@monash.edu.

Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia; Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia.

University College Dublin Clinical Research Centre at St Vincents University Hospital, Dublin, Ireland.

The Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Intensive Care, The Alfred Hospital, Melbourne, Victoria, Australia.

Intensive Care Unit, Royal Darwin Hospital, Darwin, Northern Territory, Australia; Menzies School of Health Research, Darwin, Northern Territory, Australia.

Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Australia; School of Human Movements and Nutrition Science, University of Queensland, Brisbane, Australia.

Department of Nutrition & Dietetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; School of Medicine and Health, University of Sydney, New South Wales, Australia.

Department of Allied Health (Clinical Nutrition), The Royal Melbourne Hospital, Melbourne, Victoria, Australia; The University of Melbourne, Department of Critical Care, Melbourne Medical School, Melbourne, Victoria, Australia.

Intensive Care Unit, Nepean Hospital, Sydney, New South Wales, Australia.

The Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

The Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; University College Dublin Clinical Research Centre at St Vincents University Hospital, Dublin, Ireland; Department of Intensive Care, The Alfred Hospital, Melbourne, Victoria, Australia.

Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.

Intensive Care Unit, Gold Coast University Hospital, Southport, Queensland, Australia; Menzies Health Institute, Griffith University, Southport, Queensland, Australia.

Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.

Aust Crit Care. 2023 Nov;36(6):955-960. doi: 10.1016/j.aucc.2023.01.003. Epub 2023 Jan 17.

https://pubmed.ncbi.nlm.nih.gov/36806392/?otool=iaurydwlib

https://hdl.handle.net/10137/12636

36

Adult

Humans

*COVID-19

Critical Illness

Pandemics

Australia/epidemiology

Hospitalization

*Malnutrition/epidemiology/diagnosis

Intensive Care Units

Nutrition care processes across hospitalisation in critically ill patients with COVID-19 in Australia: A multicentre prospective observational study.

Journal Article

Multicenter Study

Observational Study

Publication