Anthropometric undernutrition and mortality in surgical patients in an intensive care unit

Authors

Keywords:

Malnutrition; Anthropometry; Mortality; Intensive Care Units; Surgical Procedures, Operative.

Abstract

Malnutrition in surgical intensive care patients is a poorly studied risk factor. With the aim of identifying the association of anthropometric nutritional status with mortality in surgical patients admitted to intensive care, an analytical cross-sectional study was conducted on 58 critically ill surgical patients between 2019 and 2020. Nutritional status was classified using a pragmatic composite of grouped and isolated anthropometric measurements. Association with mortality was analyzed using χ², crude prevalence ratio, odds ratio, area under the receiver operating characteristic curve, and attributable fraction. The result was a prevalence of malnourished patients of 48.3 %. Malnourished patients had a mortality rate of 67.9 % (crude prevalence ratio: 10.19). The grouped anthropometric measurements showed good discrimination, sensitivity and specificity. Agreement between anthropometric measurement methods was adequate. From the study results, it is concluded that anthropometric undernutrition was associated with mortality in this patient group, with a high attributable clinical impact. Grouped anthropometric measurements are a valid and reproducible biomarker at the patient's bedside.

Downloads

Download data is not yet available.

References

1. Mogensen KM, Robinson MK, Casey JD, Gunasekera NS, Moromizato T, Rawn JD, Christopher KB. Nutritional Status and Mortality in the Critically Ill. Crit Care Med [internet]. 2015 [consultado 8/11/2025];43(12):2605-15. Disponible en: doi: 10.1097/CCM.0000000000001306

2. Lew CCH, Yandell R, Fraser RJL, Chua AP, Chong MFF, Miller M. Association Between Malnutrition and Clinical Outcomes in the Intensive Care Unit: A Systematic Review. JPEN J Parenter Enteral Nutr [internet]. 2017 [consultado 8/11/2025];41(5):744-758. Disponible en: doi: 10.1177/0148607115625638

3. Correia MITD, Perman MI, Waitzberg DL. Hospital malnutrition in Latin America: A systematic review. Clin Nutr [internet]. 2017 [consultado 8/11/2025];36(4):958-967. Disponible en: doi: 10.1016/j.clnu.2016.06.025

4. Rodríguez-Hernández Y, Sosa-Remón A, Ortiz-Hernández L, Matos-Lastre EA, Jerés-Alvarez AE. Factores asociados al estado nutricional de pacientes con ventilación mecánica artificial en unidad de cuidados intensivos. Rev Méd Electrón [Internet]. 2020 [consultado 8/11/2025];42(5). Disponible en: http://www.revmedicaelectronica.sld.cu/index.php/rme/article/view/3517/4911

5. Valdivia-García L. Evaluación del riesgo de desnutrición en pacientes ingresados en una Unidad de Cuidados Intensivos postquirúrgico. Rev. Cub. Tecnol. Salud. [Internet]. 2022 [consultado 8/11/2025];13(2):19-31. Disponible en: https://revtecnologia.sld.cu/index.php/tec/article/view/3105

6. Evans DC, Corkins MR, Malone A, Miller S, Mogensen KM, Guenter P, Jensen GL et al. The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper. Nutr Clin Pract [Internet]. 2021 [consultado 8/11/2025];36(1):22-28. Disponible en: doi: 10.1002/ncp.10588.

7. Quispe-Alarcón GS, Díaz-Lara Y, Soneira-Pérez J, González-García S, Berty-Gutiérrez H. Hipoalbuminemia y riesgo de muerte en pacientes críticos en una unidad polivalente. Rev. cuba. med. mil [Internet]. 2023 [consultado 8/11/2025];52(1):e02302319. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/2319

8. Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Hooper L, Kiesswetter E, Maggio M et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr [Internet]. 2022 [consultado 8/11/2025];41(4):958-989. Disponible en: doi: 10.1016/j.clnu.2022.01.024.

9. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr [Internet]. 2016 [consultado 8/11/2025];40(2):159-211. Disponible en: doi: 10.1177/0148607115621863.

10. Waitzberg DL, Caiaffa WT, Correia MI. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition [Internet]. 2001 [consultado 8/11/2025];17(7-8):573-80. Disponible en: doi: 10.1016/s0899-9007(01)00573-1.

11. Gutiérrez-Noyola A, Martos-Benítez FD, Echeverría-Víctores A, Pupo-San JY, Soto-García A, Alonso-Rodríguez L et al. Estado nutricional posquirúrgico del paciente oncológico al ingreso en una unidad de cuidados críticos. RCAN Rev Cubana Aliment Nutr [Internet]. 2015 [consultado 8/11/2025];25(1):60-75. Disponible en: https://www.medigraphic.com/pdfs/revcubalnut/can-2015/can151g.pdf

12. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, Hiesmayr M et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr [Internet]. 2019 [consultado 8/11/2025];38(1):48-79. Disponible en: doi: 10.1016/j.clnu.2018.08.037.

13. Correia MI, Campos AC; ELAN Cooperative Study. Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study. Nutrition [Internet]. 2003 [consultado 8/11/2025];19(10):823-5. Disponible en: doi: 10.1016/s0899-9007(03)00168-0.

14. Zamora-Elson M, Martínez-Carmona JF, Ruiz-Santana S. Recommendations for specialized nutritional-metabolic management of the critical patient: Consequences of malnutrition in the critically ill and assessment of nutritional status. Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC). Med Intensiva (Engl Ed) [Internet]. 2020 [consultado 8/11/2025];44(1):19-23. Disponible en: doi: 10.1016/j.medin.2020.01.007

15. Quesada-Castillo Y, León-Pérez DO, Rosales-García J, Rodriguez-Sánchez VZ, Gutiérrez-Rojas ÁR. Caracterización del estado nutricional de pacientes posoperados con complicaciones en una unidad de cuidados intensivos. Rev cuba anestesiol reanim [Internet]. 2019 [consultado 8/11/2025];18(2): 18(2):e551 . Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726-67182019000200007&lng=es.

16. Gressies C, Schuetz P. Nutritional issues concerning general medical ward patients: feeding patients recovering from critical illness. Curr Opin Clin Nutr Metab Care [Internet]. 2023 [consultado 8/11/2025];26(2):138-145. Disponible en: doi: 10.1097/MCO.0000000000000894.

17. Koontalay A, Suksatan W, Sadang JM, Prabsangob K. Optimal Nutritional Factors Influencing the Duration of Mechanical Ventilation Among Adult Patients with Critical Illnesses in an Intensive Care Unit. J Multidiscip Healthc [Internet]. 2021 [consultado 8/11/2025];14:1385-1393. Disponible en: doi: 10.2147/JMDH.S319553.

18. Alfonso-Novo L. Recomendaciones alimentarias y nutricionales para la Covid-19 en las edades pediátricas. Rev Cubana Aliment Nutr [Internet]. 30 de junio de 2020 [consultado 8/11/2025];30(1):11. Disponible en: https://revalnutricion.sld.cu/index.php/rcan/article/view/997

19. Barros J, Oviedo M, Romano ME, Villegas C, Martinuzzi A. Sobre el uso de fórmulas enterales hiperproteicas en el distrés respiratorio asociado a la Covid-19. Rev Cubana Aliment Nutr [Internet]. 2023 [consultado 8/11/2025];32(2):21. Disponible en: https://revalnutricion.sld.cu/index.php/rcan/article/view/1404

20. Santana Porbén S. Sobre la actuación nutricional en la infección por el coronavirus Sars Cov-2. Rev Cubana Aliment Nutr [Internet]. 2024 [consultado 8/11/2025];33(1):3. Disponible en: https://revalnutricion.sld.cu/index.php/rcan/article/view/1465

21. Alamri A, Alaamer K, Almogbel Y, Alsalahi H, Al Shareef M, Alanazi S et al. Prevalence of Malnutrition in People Hospitalized for Surgery: Prospective Cross-Sectional Study. Healthcare (Basel) [Internet]. 2025 [consultado 8/11/2025];13(4):380. Disponible en: doi: 10.3390/healthcare13040380.

22. Doganay M, Halil MG, Uyar M, Kocatakan P, Dikmeer A, Kelleci Cakir B et al. Prevalence of malnutrition risk in hospitalized patients: a large nationwide study. J Health Popul Nutr [Internet]. 2025 [consultado 8/11/2025];44(1):137. Disponible en: doi: 10.1186/s41043-025-00891-6.

23. Aguirre-Castro C, Díaz-Lara Y, Soneira-Pérez J, Castro-Iglesias D, Castro-Iglesias M, Torres-Pérez L. Riesgo nutricional y su relación con la morbilidad y la mortalidad en pacientes graves. Revista Finlay [Internet]. 2025 [consultado 8/11/2025];15:0. Disponible en: https://revfinlay.sld.cu/index.php/finlay/article/view/1580

24. Chávez-Pérez CE, Méndez-Lozano D, Muñoz-Ramírez MR, Sánchez-Nava VM. Identificación de factores de riesgo asociados a mortalidad en el paciente quirúrgico de alto riesgo en una Unidad de Cuidados Intensivos. Medicina Crítica [Internet]. 2013 [consultado 8/11/2025];27(1):15-24. Disponible en: https://www.medigraphic.com/pdfs/medcri/ti-2013/ti131c.pdf

25. Hernández-González J, Rodríguez-Ramos W, Breijo-Puentes A, Sánchez-Portela C. Prevalencia de la desnutrición hospitalaria en los hospitales “Abel Santamaría” y “León Cuervo Rubio”. Rev Cubana Aliment Nutr [Internet]. 2021 [consultado 8/11/2025];17(1):11. Disponible en: https://revalnutricion.sld.cu/index.php/rcan/article/view/1151

26. Estimación del riesgo nutricional y su relación con la tasa de mortalidad en una Unidad de Cuidados Intensivos. ATI [Internet]. 2021[consultado 8/11/2025];38:e742.23032021 Disponible en: https://revista.sati.org.ar/index.php/MI/es/article/download/742/885

Published

2026-01-23

How to Cite

1.
Baldor Illanas YJ, Sosa Remón A, Ortiz Hernández L, Auza-Santivañez JC, Matos Lastre EA. Anthropometric undernutrition and mortality in surgical patients in an intensive care unit. RM [Internet]. 2026 Jan. 23 [cited 2026 Jan. 28];30:e3256. Available from: https://revmultimed.sld.cu/index.php/mtm/article/view/e3256

Issue

Section

ARTÍCULOS ORIGINALES