RT Journal Article
SR Electronic
T1 Penn State equation versus indirect calorimetry for nutritional assessment in patients with traumatic brain injury
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP E320
OP E325
DO 10.1503/cjs.022420
VO 65
IS 3
A1 Wu, Sonia
A1 Iqbal, Sameena
A1 Giroux, Melanie
A1 Alam, Norine
A1 Campisi, Josie
A1 Razek, Tarek
A1 Deckelbaum, Dan
A1 Grushka, Jeremy
A1 McKendy, Katherine
A1 Wong, Evan
A1 Marcoux, Judith
A1 Khwaja, Kosar A.
YR 2022
UL http://canjsurg.ca/content/65/3/E320.abstract
AB Background: Nutritional assessment can be challenging in patients with traumatic brain injury (TBI), and indirect calorimetry may be a more suitable method than predictive equations. We compared the Penn State equation versus the gold standard of indirect calorimetry for the nutritional assessment of patients with TBI, and quantified the difference between nutritional requirements and actual patient intake.Methods: This single-centre, prospective cohort study included patients with moderate (Glasgow Coma Scale score 9–12) and severe (Glasgow Coma Scale score 3–8) TBI admitted to the Montreal General Hospital intensive care unit (ICU) between June 2018 and March 2019. Penn State equation estimates and indirect calorimetry measurements were collected, and actual intake was drawn from medical records. We compared the 2 assessment methods using a Spearman correlation coefficient.Results: Twenty-three patients with TBI (moderate in 7 and severe in 16) were included in the study. Overall, there was a moderate positive correlation between the Penn State equation estimate and indirect calorimetry readings (correlation coefficient 0.457, p = 0.03); however, the correlation was weaker in severe TBI (correlation coefficient 0.174, p = 0.5) than in moderate TBI (correlation coefficient 0.929, p = 0.003). When compared to indirect calorimetry assessment, patients received 5.4% (p = 0.5) of required intake on the first day and 43.9% (p = 0.8) of required daily intake throughout their ICU stay.Conclusion: Patients with moderate or severe TBI in the ICU received less than 50% of their nutritional requirements. The difference between the Penn State equation and indirect calorimetry assessments was most noticeable for patients with severe TBI, which indicates that indirect calorimetry may be a more suitable tool for assessment of nutritional needs in this population.