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Cited by 201Clinical Nutrition and GastroenterologyBody Composition Measurement TechniquesDietetics, Nutrition, and Education

Accurate Determination of Energy Needs in Hospitalized Patients

Boullata, Joseph, Williams, Jennifer, Cottrell, Faith, Hudson, Lauren, Compher, Charlene·2007·Journal of the American Dietetic Association
DOI 10.1016/j.jada.2006.12.014
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Abstract

Objective To evaluate the accuracy of seven predictive equations, including the Harris-Benedict and the Mifflin equations, against measured resting energy expenditure (REE) in hospitalized patients, including patients with obesity and critical illness. Design A retrospective evaluation using the nutrition support service database of a patient cohort from a similar timeframe as those used to develop the Mifflin equations. Subjects/setting All patients with an ordered nutrition assessment who underwent indirect calorimetry at our institution over a 1-year period were included. Intervention Available data was applied to REE predictive equations, and results were compared to REE measurements. Main outcome measures Accuracy was defined as predictions within 90% to 110% of the measured REE. Differences >10% or 250 kcal from REE were considered clinically unacceptable. Statistical analyses performed Regression analysis was performed to identify variables that may predict accuracy. Limits-of-agreement analysis was carried out to describe the level of bias for each equation. Results A total of 395 patients, mostly white (61%) and African American (36%), were included in this analysis. Mean age+/-standard deviation was 56+/-18 years (range 16 to 92 years) in this group, and mean body mass index was 24+/-5.6 (range 13 to 53). Measured REE was 1,617+/-355 kcal/day for the entire group, 1,790+/-397 kcal/day in the obese group (n=51), and 1,730+/-402 kcal/day in the critically ill group (n…

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  • Energy requirements in polymorbid medical inpatients can be estimated using indirect calorimetry, a published prediction equation or a weight-based formula, although the accuracy of prediction equations in this population is low.

    “Energy requirements in polymorbid medical inpatients can be estimated using indirect calorimetry (IC), a published prediction equation or a weight-based formula, although the accuracy of prediction equations in this population is low.”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [66]

  • More than 200 prediction equations have been published, with accuracy rates ranging from 36% to 75% when compared with IC, and no single equation is most accurate in polymorbid medical inpatients.

    “More than 200 prediction equations have been published in the literature, with accuracy rates ranging from 36% to 75% when compared with IC and no single equation emerges as being the most accurate in polymorbid medical inpatients [66].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [66]

  • Both published prediction equations and weight-based formulae provide valid estimates of energy requirements for groups of patients, but both are subject to significant bias and imprecision when applied to individuals.

    “While both published prediction equations and weight-based formulae provide valid estimates of energy requirements for groups of patients, both methods are subject to significant bias and imprecision when applied to individuals [66,67].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [66]

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Authors
Boullata, J., Williams, J., Cottrell, F., Hudson, L., & Compher, C.
Affiliations
University of Pennsylvania (US)
Corresponding author
Boullata, Joseph
ORCID
Venue
Journal of the American Dietetic Association
Publisher
Elsevier BV
Published
2007-03
Volume
107
Issue
3
Pages
393-401
ISSN
0002-8223 (ISSN-L)
DOI
10.1016/j.jada.2006.12.014
OpenAlex
W1985458679
Cited by
201
References
43
Citations by year
2026: 4 · 2025: 6 · 2024: 1 · 2023: 13 · 2022: 10 · 2021: 6 · 2020: 11 · 2019: 9 · 2018: 8 · 2017: 21 · 2016: 17 · 2015: 18 · 2014: 8 · 2013: 13 · 2012: 16
FWCI
9.90
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Dietetic Association (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
Keywords
resting energy expenditure, load forecasting, Harris-Benedict equation, Mifflin equation, indirect calorimetry, hospitalized patients, obesity, critical illness, nutritional assessment, limits of agreement, body mass index, hospitalized adolescents, hospitalized adults, hospitalized older adults, hospitalized pregnant women
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Basal Metabolism, Energy Intake, Calorimetry, Indirect, Energy Metabolism, Female, Hospitalization, Humans, Male, Mathematics, Middle Aged, Nutritional Requirements, Obesity, Predictive Value of Tests, Retrospective Studies, Sensitivity and Specificity, Reproducibility of Results, Cohort Studies, Logistic Models, Critical Illness

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