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Cited by 34Sepsis Diagnosis and TreatmentClinical Nutrition and GastroenterologyHyperglycemia and glycemic control in critically ill and hospitalized patients

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Insufficient Nutrition and Mortality Risk in Septic Patients Admitted to ICU with a Focus on Immune Dysfunction

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Hung, Kai-Yin, Chen, Yu-Mu, Wang, Chin-Chou, Wang, Yi-Hsi, Lin, Chiung-Yu, Chang, Ya-Ting, Huang, Kuo-Tung, Lin, Meng-Chih, Fang, Wen-Feng·2019·Nutrients
DOI 10.3390/nu11020367PMC PMC6412372
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Abstract

Immune dysfunction is seen both in sepsis patients and in those with malnutrition. This study aimed to determine whether insufficient nutrition and immune dysfunction have a synergistic effect on mortality in critically ill septic patients. We conducted a prospective observational study from adult sepsis patients admitted to intensive care units (ICUs) between August 2013 and June 2016. Baseline characteristics including age, gender, body mass index, NUTRIC, Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were recorded. Immune dysfunction, defined by human leukocyte antigen DR (HLA-DR) expression, was tested at days 1, 3, and 7 of ICU admission. The study included 151 patients with sepsis who were admitted to the ICU. The 28-day survivors had higher day 7 caloric intakes (89% vs. 73%, p = 0.042) and higher day 1-HLA-DR expression (88.4 vs. 79.1, p = 0.045). The cut-off points of day 7 caloric intake and day 1-HLA-DR determined by operating characteristic curves were 65.1% and 87.2%, respectively. Immune dysfunction was defined as patients with day 1-HLA-DR < 87.2%. Insufficient nutrition had no influence on survival outcomes in patients with immune dysfunction. However, patients with insufficient nutrition had poor prognosis when they were immune competent. Insufficient nutrition and immune dysfunction did not have a synergistic effect on mortality in critically ill septic patients.

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  • Underfeeding patients with a marked immune disturbance did not prove harmful, whereas underfed immunocompetent patients had the worst prognosis.

    “However, underfeeding patients with a marked immune disturbance did not prove harmful, whereas underfed immunocompetent patients had the worst prognosis.”

    From Nutrition in Sepsis: A Bench-to-Bedside Review. (2020) · cites this paper as [19]

  • Insufficient nutrition and immune dysfunction had no synergistic effect on mortality in critically ill septic patients.

    “Insufficient nutrition and immune dysfunction had no synergistic effect on mortality in critically ill septic patients [19].”

    From Nutrition in Sepsis: A Bench-to-Bedside Review. (2020) · cites this paper as [19]

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Metadata

Authors
Hung, K.-Y., Chen, Y.-M., Wang, C.-C., Wang, Y.-H., Lin, C.-Y., Chang, Y.-T., Huang, K.-T., Lin, M.-C., & Fang, W.-F.
Affiliations
  • Chang Gung University (TW)
  • Chang Gung University of Science and Technology (TW)
Corresponding author
Fang, Wen-Feng
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2019-02-10
Volume
11
Issue
2
Pages
367
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu11020367
PMC
PMC6412372
OpenAlex
W2912939951
Cited by
34
References
5
Citations by year
2026: 5 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 2 · 2020: 3 · 2019: 4
FWCI
2.66
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Kaohsiung Chang Gung Memorial Hospital (CMRPG8B1063, CMRPG8F1331, CMRPG8H1171, CMRPG8B1073 and CMRPG8B1083)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
sepsis, malnutrition, immune dysfunction, HLA-DR expression, mortality, intensive care unit, energy intake, prognostic factors, NUTRIC score, APACHE II score, SOFA score
MeSH terms
Aged, Aged, 80 and over, Critical Care, Female, Hospitalization, Humans, Immune System Diseases, Male, Middle Aged, Nutritional Status, Prognosis, Prospective Studies, ROC Curve, Critical Illness, Sepsis, Malnutrition, Organ Dysfunction Scores

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