Predictors for achieving protein and energy requirements in undernourished hospital patients

Background & aims: Providing sufficient protein an energy is considered crucial in the treatment of undernutrition. Still, the majority of undernourished hospital patients have a suboptimal protein and energy intake. The aim of this study was to investigate predictors for achieving protein and energy requirements on the fourth day of admission in undernourished hospitalized patients. Methods: 830 adult undernourished patients (SNAQ >= 3) were retrospectively included. Intake requirements were defined as >= 1.2 g protein per kg bodyweight and >= 100% of the energy requirement based on calculated resting energy expenditure according to Harris & Benedict + 30%. Logistic regression analyses were performed to investigate predictors for achieving the requirements. Results: Protein and energy intake had been recorded for 610 patients, of whom 25.6% had sufficient protein and energy intake. Protein requirements were less commonly met than energy requirements. Complete case analyses (n = 575) showed that negative predictors for achieving the protein and energy requirements were: nausea (OR = 0.18; 95%CI = 0.06-0.53), cancer (0.57; 0.35-0.93), acute infections (0.63; 0.37-1.01) and higher BMI (0.84; 0.79-0.89). Positive predictors were: a higher age (1.01; 1.00 -1.03), chronic lung disease (3.76; 2.33-6.07) and receiving tube feeding (3.89; 1.56-9.73). Conclusion: Only one in four undernourished hospital patients meets the predefined protein and energy requirements on the fourth day of admission. Nausea, cancer, acute infections, BMI, age, chronic lung disease and tube feeding were identified as predictors for achieving protein and energy intake. (C) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.