AUTHOR=Bong Jeong Bin , Kim So-Yeong , Ryu Han Uk , Kang Hyun Goo 

TITLE=Factors affecting target caloric achievement and calorie intake improvement: the nutrition support team's role

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 10 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1249638

DOI=10.3389/fnut.2023.1249638

ISSN=2296-861X

ABSTRACT=The nutrition support team (NST) works to improve malnutrition in hospitalized patients, and its role is expanding as more hospitals adopt NST. This study aimed to identify the clinical characteristics of NST-referred patients admitted to a tertiary hospital. 
This study examined 1,171 adult patients (aged ≥18 years) who were referred to the NST from all the departments within a tertiary hospital at least twice, with a minimum one-week interval between referrals, between January 1, 2019, and December 31, 2020. The study participants consisted of patients receiving less than 75% of their required caloric intake at the time of their first NST referral. Patients were categorized and compared according to whether they achieved their target calorie intake regardless of the period after the first 2. This is a provisional file, not the final typeset article NST referral and whether they improved their calorie intake one week after the NST therapy. We then identified factors affecting target caloric achievement and improvement in calorie intake.
The group that achieved the target calorie intake had a lower proportion of neuro department patients (31.3%), a higher proportion of patients receiving intensive care unit (ICU) care (31.9%), and a longer ICU stay (p<0.001) than the group that did not achieve the target calorie intake. Neuro department admission negatively affected target caloric achievement (adjusted odds ratio [aOR]=0.305, 95% confidence interval [CI]=0.150-0.617), whereas the length of ICU stay positively affected target caloric achievement (aOR=1.025, 95% CI=1.007-1.043). The proportion of neuro department patients was also low (42.5%) in the group with improved calorie intake one week after NST therapy. Neuro department admission was a negative factor (aOR=0.376, 95% CI=0.264-0.537) affecting the improvement in calorie intake.
NST therapy significantly improved clinical outcomes for inpatients at nutritional risk. Because achieving target calories and improving calorie intake in neuro department patients is difficult, it is necessary to actively refer them to NST to achieve the target calories and improve calorie intake. Furthermore, because a longer ICU stay positively affects target calorie achievement, the system for ICU nutrition therapy should be expanded and implemented for general-ward patients, including neurological patients.